Improving the early detection of malignant melanoma.

The early detection of cutaneous melanoma is known to be associated with reduced mortality. In order to improve early detection of suspicious skin lesions a Pigmented Lesion Clinic (PLC) was set up at Mount Vernon Hospital in January 1993. Its aims were to provide a rapid method of expert assessment and treatment for malignant skin tumours as well as reassurance for patients with benign lesions. In the first 2 years, 1779 new patients were seen and 674 lesions excised, of which 18% were malignant. Comparison of the Breslow thicknesses of melanomas diagnosed via the PLC revealed a significant shift towards thinner early tumours when compared with the two previous years (chi 2 = 12.8, P < 0.01) and during the same time period via normal routes of referral (chi 2 = 8.68, P < 0.02). The running of such a service and its hidden benefits are discussed.