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.
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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