Benign or suspicious? A simple way to approach skin lesions

A simple approach used in practice is to first determine whether a lesion is benign or suspicious, rather than trying to make a precise diagnosis.

One useful framework (the BEST protocol — Benign vs Suspicious) is to ask:

• Can I name it? If the lesion is clearly recognisable, it is more likely to be benign.
• Is it new? New lesions should always prompt closer attention.
• Is it changing? Any reported change increases suspicion.

In practice, this becomes a simple decision:

• If you can name the lesion, and it is not new and not changing → likely benign → no action required
• If you cannot confidently identify it, or it is new or changing → suspicious → biopsy, excise or refer

Importantly, this approach avoids unnecessary delay. If a lesion is suspicious, monitoring is generally not considered a safe option and a definitive step should be taken. This kind of structured thinking can make skin checks more efficient and support more confident decision-making in everyday practice.

For those looking to build these skills further, GPRA members are eligible for a scholarship of up to $500 on select HealthCert Education certificate courses by using the code GPRA2026, designed to support practical, real-world learning in general practice.

Learn more here