Melanoma diagnosis and management after the introduction of a pigmented lesion clinic in the Mid-West of Ireland

Abstract

A pigmented lesion clinic (PLC) was introduced and Consultant Dermatology posts were increased in the Mid-West of Ireland with the aim of improving early detection of melanoma. We analysed retrospectively the invasive melanomas excised in the Mid-West of Ireland over a 2-year period prior to (2010-2011) and after (2013-2014) the advent of the PLC. The number of melanomas excised almost doubled from 54 (2010-2011) to 107 (2013-2014). There was a significant rise in the rate of excision biopsies performed by Dermatologists compared to non-dermatology clinicians from 19 to 56% (p<0.0001). There was a significant difference in the diagnostic accuracy of excised melanomas by Dermatologists compared to non-dermatology clinicians during both time periods (2010-2011: p=0.001; 2013-2014: p<0.0001). There was a non-significant decrease in the median Breslow thickness of melanomas from 1.3mm (0.6-2.6) (2010-2011) to 1.0mm (0.5-2.3) (2013-2014) (n=145, p=0.48). The PLC has led to an increase in the number of melanomas excised by Dermatologists in the Mid-West of Ireland which has led to higher diagnostic accuracy.