Litigation as a result of delay in the diagnosis of malignant melanoma occurs frequently. It may arise from the failure of the GP, the dermatologist or the pathologist.
Malignant melanoma may arise de novo as a small black speck which gradually progresses to a substantial tumour. Alternatively, and more usually, it arises from a naevus which may have been present for many years.
NICE and the BAD have issued guidelines to enable GPs and dermatologists to identify malignant melanomas and to differentiate them from benign skin lesions. Members of the legal profession tend to rely on these guidelines. As a result clinicians either discharge patients who do not have the characteristic features of malignant melanomas or keep them on follow up until the characteristic features develop.
Patients frequently present as the horizontal growth phase is changing to a vertical growth phase. At this time no features of malignancy may be apparent.