ARE PIGMENTED LESION CLINICS WORTHWHILE

To assess the effect of a pigmented lesion clinic on referral patterns and thickness of melanoma at presentation, we have compared data from the centralized pathology services of the adjacent health authorities of Wandsworth, and Merton and Sutton. Both districts were the subject of a CRC public awareness campaign in 1987, but only Wandsworth is se rved by a pigmented lesion clinic. All patients presenting with malign ant melanoma were included; from 1981 to 1990 for Wandsworth, and from 1984 to 1990 for Merton and Sutton. The Breslow thickness and clinic source of all melanomas was documented. Approximately equal numbers of melanomas were seen in the two districts, with no obvious difference in the numbers of thin (< 1.5 mm thick) 'good prognosis' tumours. Both districts saw an increase in the total number of tumours, and the num ber of thin tumours, after the CRC publicity campaign. However, there was considerable cross-boundary referral to the pigmented lesion clini c in Wandsworth, with 60% of all melanomas coming from outside the dis trict. The presence of a pigmented lesion clinic within a given distri ct confers no obvious benefit with regard to the number of thin, 'good prognosis' melanomas being seen as a whole, but the cross-boundary re ferral pattern suggests that it fulfils a demand from both general pra ctitioners (GPs) and patients, and it does provide a centralized sourc e for the collection of much-needed data.