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Lentigo Maligna and Lentigo Malignant Melanoma

Photos for Lentigo Maligna - click on tab labelled Lentigo.
Photos for Lentigo Malignant Melanoma - click on tab labelled Lentigo maligna melanoma.

Lentigo maligna is a brown patch, generally on the face of the elderly. This precursor lesion leads to lentigo maligna melanoma. Clinically it is a spreading brown patch, often with considerable variation in colour. It is absolutely flat. It can slowly expand for decades. Over time, a nodule can develop within it, lentigo maligna melanoma.

Lentigo maligna and lentigo maligna melanoma occur most often in areas of maximal sun exposure on the face. This is unlike other types of melanoma that tend to predominate in areas of intermittent severe sun exposure. The distribution of lentigo maligna lesions on the face closely parallels that of actinic keratoses, and squamous carcinoma.

Lentigo maligna can be confused with lentigo simplex. Elderly people frequently develop brown patches on the face secondary to actinic damage. Only in a few cases is this lentigo, lentigo maligna. An incisional shave biopsy, submitted to a dermatopathologist, with an appropriate history, will establish whether the brown patch is benign or premalignant.

The treatment of choice of lentigo maligna is surgical excision if the lesion is small. Radiation therapy is frequently the treatment of choice in the elderly with an extensive lesion. These lesions should not be treated with liquid nitrogen cryotherapy, as a rule, because the dysplastic melanocytes go down hair follicles and deep recurrence post-cryotherapy is common.

SOURCE: Lentigo Maligna and Lentigo Malignant Melanoma ( )
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