A pilot scheme is underway in the Plastic Surgery Department at the Royal Preston Hospital which will assess the diagnostic accuracy for skin lesions, using professional digital imaging technology.  If the pilot is a success it is thought that digital imaging will assist in the future prioritisation of skin lesions and enable some patients to be directly listed for day case surgery without attending the outpatients department.  Digital imaging also has the potential to assist in the management of the Governments target to see all patients with suspected skin cancer within 2 weeks of referral.  The 3 month trial involves patients referred with skin lesions who are scheduled to attend Mr Howcroft or Mr Jones outpatients clinics in February, March and April 2000.  Patients will be advised that they are under no obligation  to participate in the trial, and that their future treatment will not be affected in any way.  Ethical approval has been given for the trial  to proceed and consent will tbe taken from each patient who participates.  Patients will be invited to attend the Medical Illustration Department to have a high resolution digital image taken of the skin lesion.  The two participating consultants will then assess the digital images along with the GP referral letter and make a diagnosis.  To mensure a validity of the digital image diagnosis, the patient will have to be seen in the outpatient department.  For those patients who go on to have surgery, histological confirmation of the diagnosis will be undertaken.  Data will be collected at each stage of the patient episode with the following aims:  Assessment of the quality of GP referrals; assessment of GP diagnostic accuracy; assessment of GP prioritisation of referrals; assessment of Consultant's diagnostic accuracy based on digital image plus GP referral information; assessment of Consultants prioritisation of referrals; identification of patients who could be directly listed for day case surgery.