Improving detection of XXXX @entity1489 .

@entity1 @entity5 @entity1489 @entity957 @entity1066 @entity272 @entity1490 @entity320 @entity1491
@entity1491 ( @entity1491 ) and @entity957 ( @entity957 ) are clinically and pathologically distinct and both are locally invasive. However, while @entity1491 rarely metastasise, @entity957 have the potential to do so especially when they arise on the ears or lips. UV radiation is the most important risk factor for @entity1489 ( @entity1489 ). The @entity5 most commonly arise in fair-skinned individuals on sun-damaged skin, especially the face. Incidence rises with age. @entity1 with one @entity1489 have a higher risk of developing another @entity1489 and of @entity320 . @entity957 are frequently more difficult to diagnose than @entity1491 . Well differentiated lesions have a pronounced keratotic element. Poorly differentiated @entity957 tend to be pink or red papules or nodules, lacking keratin, which may ulcerate. Around 5% of @entity957 metastasise. High-risk @entity957 include those: on the ear, lip, or sites unexposed to the sun and in chronic @entity1066 , scars or @entity1490 . @entity957 > 20 mm in diameter or > 4 mm in depth are high risk. @entity1 who are immunosuppressed, have poorly differentiated @entity5 or recurrent disease are also at increased risk. @entity1 with a slowly evolving or persistent @entity272 where @entity5 is a possibility should be referred to a dermatologist. Lesions suspected of being BCC should be referred routinely. Urgent referral should be reserved for cases where there is concern that a delay may have a significant impact because of the size or site of the lesion. Any non-healing lesions >1 cm with marked induration on palpation, showing significant expansion over eight weeks, should be referred urgently as they may be @entity957 .
