In their paper Murchie et al pose the question of whether it matters if the excision of primary cutaneous melanoma is performed in primary care by GPs. We refute the conclusion that this is a way to expedite diagnosis or that it should lead to a change in guidelines. Their results should not be seen as providing commissioners with alternatives to referring all suspected melanomas for specialist assessment as recommended in current guidelines from National Institute of Health and Clinical Excellence and British Association of Dermatologists/British Association of Plastic Reconstructive and Aesthetic Surgeons updated last year. Eight out of 11 studies of skin cancer excisions showed that clearance is more adequately achieved by dermatologists/specialists.
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