3.3.6 Lentigo Maligna
Grading & Level of Importance: B
Hutchinson melanotic freckle; lentigo maligna melanoma in situ.
10-15% of all melanoma. Slight female predominance.
Intraepithelial proliferation of atypical melanocytes mostly in sun-damaged skin and in elderly patients.
Aetiology & Pathogenesis
Chronic natural and artificial UV exposure.
Signs & Symptoms
Irregularly pigmented macule or patch with irregular borders, not palpable, slow growing.
Sun-exposed areas (face and neck area, forearms, shins).
In situ melanocytic proliferation.
Laboratory & other workups
Epidermal atrophy, increased number of atypical melanocytes in basal layer, also extending into hair follicle, dermal lymphocytic infiltrate, melanophages, solar elastosis.
Lesions slowly extending and finally developing into a lentigo maligna melanoma.
Lentigo maligna melanoma and metastasis.
Clinical features and histology.
Lentigo simplex, solar lentigo, flat seborrhoeic keratoses, melanoma (lentigo maligna melanoma, superficial spreading melanoma Level 1), naevoid lentigo, atypical naevi.
Prevention & Therapy
Depends on the size and location. Excision is preferred. If excision is not possible or otherwise contraindicated, soft X-ray treatment.
Patients should be diagnosed and treated in experienced dermatological settings.
Further Images / DOIA
- E. Samaniego, P. Redondo: Lentigo Maligna (2013)
- J.R. Kallini, S.K. Jain, A. Khachemoune: Lentigo Maligna: Review of Salient Characteristics and Management (2013)
- G.J. SMALBERGER, D.M. SIEGEL, A. KHACHEMOUNE: Lentigo maligna (2008)
- J.M. Kasprzak, Y.G. Xu: Diagnosis and management of lentigo maligna: a review (2015)
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