Please select the eligibility criteria that correspond to the clinical trial below.
Title: Melanomas Excised in Primary Care vs Secondary Care Excision
Brief Summary: Melanoma is the most dangerous skin cancer and is becoming commoner, largely due to increased foreign holidays and use of sun-beds. Melanoma usually begins as a new or changing mole. If it is picked-up quickly enough it can be removed in a simple operation and effectively cured. GPs can do this operation and many are highly experienced and skilled in minor skin surgery. However, guidelines written by hospital specialists insist that all patients who might have a melanoma should not be treated by GPs, but should be referred to hospital. This contrasts with Australia, where melanoma is commoner and initial treatment by GPs is standard practice. This creates several potential problems. First, melanoma can be difficult to diagnose. Many moles that do not look concerning based on checklists do turn out to be melanoma, and the opposite frequently occurs too, moles that look worrying at initial examination are not melanoma. Second, people are becoming more skin aware and GPs are checking moles much more often. Sensibly many of these patients are being sent to hospital for a check, although most will not have melanoma. Third, as a result hospital skin clinics and minor surgery lists are becoming very busy and waiting times are ever increasing. Fourth, the many people who have a melanoma that is not clinically obvious are waiting an increasingly long time to have it diagnosed and treated in hospital, and this could actually mean that melanoma has more chance to spread while they wait. The investigators conducted studies on 1200 people diagnosed with a melanoma in Northeast Scotland between 1991 and 2008 and found that 20% of these people had had their melanoma diagnosed and first treated by their GP. These patients were no more likely to receive improper treatment than those that had been referred to hospital. Also people who had had their melanoma cut out by a GP were no more likely to die from melanoma, and they actually required less hospital visits afterward. This suggests that the guidelines could be changed to allow GPs to treat suspicious moles. The investigators think this will be better for patients and the NHS in the long-run. However, the investigators cannot recommend changes to the guidelines on the basis of local research. For this reason, the investigators wish to extend the study using data from 18,000 patients diagnosed with melanoma from across Scotland. The results of this inclusive study will inform how the health service should deal with the growing problem of suspicious moles in the future.


Options:
A: Inclusion Criteria:

* Patients with clinically suspected new primary BCC as assessed by an experienced board certified dermatologist
* Patients seen at the outpatient clinic before 12h00 AM will be eligible to participate
* Patient is willing and able to give written informed consent
* BCC lesion is suitable for conventional surgical excision under local anesthetics
* BCC lesion is present since at least 1 month

Exclusion Criteria:

* BCC lesion in a high-risk location of the face (H-zone and ears)
* Contra-indication for conventional surgical excision (primary surgical closure seems not achievable)
* Recurrent BCC lesion (BCC that has been previously unsuccessfully treated) Macroscopic ulcerating BCC lesions (not feasible for RCM analysis due to technical reasons)
* Patients with basal cell nevus syndrome
* Patients treated with hedgehog inhibitor medication
* Patients with a history of hypersensitivity to and/ or a history of allergy to local anesthesia
* Unavailability within the following 6 weeks (for example due to holiday or sports)
* Patients not competent to understand the procedures involved
B: Inclusion Criteria:

* Patients must be able to adhere to all requirements of the study
* Patients must be willing to give written informed consent
* Clinically diagnosed/ clinical suspicion of basal cell carcinoma

Exclusion Criteria:

* Participating in other investigational research currently or in the previous 28 days before the study
* Patient is having a medical condition which excludes participating the research, according to the investigator
* Incapacitated subjects will not be included
* Lesion(s) on parts of the body which do not allow to adequately image the tumour with RCM.
C: Inclusion Criteria:

* A diagnosis of malignant melanona

Exclusion Criteria:

* None
D: Inclusion Criteria:

* The lesion is pigmented (i.e., melanin, keratin, blood)
* Clinical management of the lesion by the examining dermatologist is either biopsy of the lesion in toto, or 3-month follow-up of the lesion
* The diameter of the pigmented area is between 2 and 22 millimeters
* The lesion is accessible to the MelaFind hand-held imaging device
* The patient, or a legally authorized representative, has consented to participate in the study and has signed the Informed Consent Form

Exclusion Criteria:

* The patient has a known allergy to isopropyl alcohol
* The lesion has been previously biopsied, excised, or traumatized
* The skin is not intact (e.g., open sores, ulcers, bleeding)
* The lesion is within 1 cm of the eye
* The lesion is on mucosal surfaces (e.g., lips, genitals)
* The lesion is on palmar hands
* The lesion is on plantar feet
* The lesion is on or under nails
* The lesion is located on or in an area of visible scarring
* The lesion contains foreign matter (e.g., tattoo, splinter, marker)

Answer: C