Presentation
Lentigo maligna presents as a flat macule with geographic shape with coloration from tan to brown to black. [medicine.uiowa.edu]
This presented a significant interpretational problem. [f1000research.com]
Clinically, it presents as a slow-growing, asymmetric macule with irregular, poorly-defined borders and varied pigmentation. Areas of partial regression within the lesion are not uncommon. [ijdvl.com]
[…] the face, presenting as a single large evolving pigmented lesion with changing color. ( With permission from Usatine RP, Moy RL, Tobinick EL, Siegel DM. [accessmedicine.mhmedical.com]
A case is presented demonstrating the features of this malignant melanoma with an exceptionally good prognosis. The importance of the clinical and histologic correlation is emphasized to ensure proper diagnosis and treatment. [journals.sagepub.com]
Entire Body System
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Hutchinson's Triad
It should not be confused with numerous other Hutchinson named entities including: Hutchinson triad Hutchinson pupil Hutchinson teeth Hutchinson sign Hutchinson syndrome History and etymology It is named after Sir Jonathan Hutchinson (1828-1913), English [radiopaedia.org]
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Outdoor Worker
Thus lentigo maligna is more common in outdoor workers, in older people and in association with solar damage and keratinocyte skin cancer ( basal cell carcinoma, squamous cell carcinoma ). [dermnetnz.org]
Jaw & Teeth
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Microstomia
There were no signs of local recurrence and no obvious deformity (modiolus alteration or microstomia) during a follow-up visit after 3 months. Figure 2: Multicomponent pattern. [ijdvl.com]
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Hutchinson's Teeth
It should not be confused with numerous other Hutchinson named entities including: Hutchinson triad Hutchinson pupil Hutchinson teeth Hutchinson sign Hutchinson syndrome History and etymology It is named after Sir Jonathan Hutchinson (1828-1913), English [radiopaedia.org]
Skin
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Blister
[…] brachytherapy moulage technique. ( 20874783 ) Sachse MM...Liebmann A 2011 48 Lentigo maligna: melanoma in situ on chronically sun-damaged skin. ( 21732771 ) Reed JA...Shea CR 2011 49 Underlying amelanotic lentigo maligna melanoma uncovered after a severe blistering [malacards.org]
Past episodes of severe sunburn, often with blisters, and particularly in childhood, increase the risk of developing them. However, not all of them are due to sun exposure, and some appear in areas that are normally kept covered. [esms-mohs.eu]
Treatment
Carbon dioxide laser ablation may have a role in treatment of LM when standard treatments are refused or unsuitable, however there is currently only weak evidence of its efficacy. [wiki.cancer.org.au]
The treatment of LM with Imiquimod is off-label. A few case reports and small case series exist for other topic treatment modalities such as ingenol mebutate, 5-fluorouracil and topical retinoids. [thieme-connect.com]
Other treatment modalities for LM have been studied but none of them still has proved to be efficient enough. Recently, photodynamic treatment (PDT) has been suggested as a promising novel treatment method for LM. [clinicaltrials.gov]
RT is superior to surgery in conserving normal tissue 15 within the treatment field. RT can be used in LM as definitive treatment or as adjuvant treatment on finding positive margins following excision. [onlinelibrary.wiley.com]
[…] n F 2012 46 Geometric staged excision for the treatment of lentigo maligna and lentigo maligna melanoma: a long-term experience with literature review. ( 22782151 ) Abdelmalek M...Hruza G 2012 47 Treatment of extensive lentigo maligna melanoma of the [malacards.org]
Prognosis
A case is presented demonstrating the features of this malignant melanoma with an exceptionally good prognosis. The importance of the clinical and histologic correlation is emphasized to ensure proper diagnosis and treatment. [journals.sagepub.com]
Prognosis The prognosis for LM/LMM excellent. [statpearls.com]
Does pregnancy influence melanoma prognosis? A meta-analysis. Melanoma Res. 2017 Apr 20. [Medline]. Gray MR, Martin Del Campo S, Zhang X, Zhang H, Souza FF, Carson WE 3rd, et al. [medscape.com]
We present a case in which, during Mohs excision, a nodule of severely atypical melanocytes appeared to lie within the dermis, potentially altering treatment and prognosis. [f1000research.com]
Etiology
Solar radiation in the etiology of cutaneous malignant melanoma in Caucasians. Natl Cancer Inst Monogr. 1982; 62 :167-71. [ PubMed : 7167183 ] 9. Holman CD, Armstrong BK. [ncbi.nlm.nih.gov]
Etiology The major risk factor for development of LM/LMM is ultraviolet radiation (UVR), in particular cumulative lifetime UVR exposure. [6] [7] [8] [9] Several studies have demonstrated that LM/LMM is strongly associated with chronic UVR exposure, as [statpearls.com]
Epidemiology
The PRISMA (Preferred Reporting Itens for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-analysis Of Observational Studies in Epidemiology) guidelines were followed for data extraction. [dovepress.com]
Epidemiology, screening, and clinical features. J. Am. Acad. Dermatol. 2015 Aug; 73 (2):181-90, quiz 191-2. [ PubMed : 26183967 ] 25. Buettner PG, Leiter U, Eigentler TK, Garbe C. [ncbi.nlm.nih.gov]
The epidemiology of LM/LM melanoma might be changing. Full body examination and dermoscopy are of the utmost importance for the diagnosis. [karger.com]
A previous epidemiological publication showed a cumulative risk of LMM of 2–3% in patients with LM (histologically confirmed) after 25 years of follow‐up. 1 If there is a clinical suspicion of LM, current guidelines advise sampling with (punch or incisional [onlinelibrary.wiley.com]
[…] to occur in genetic conditions that predispose to sun sensitivity, including oculocutaneous albinism, xeroderma pigmentosum, Werner syndrome, and porphyria cutanea tarda. [2] There have been no associations demonstrated with smoking or alcohol. [17] Epidemiology [statpearls.com]
Pathophysiology
[…] between 1990-2000. [18] It is unclear whether these data represent true increases in incidence or improved diagnosis. [24] The faster rise in incidence of MIS compared to invasive melanoma suggests that detection bias plays some role at least. [25] Pathophysiology [statpearls.com]
Prevention
Lentigo maligna melanoma is more likely to return than some other types of skin cancer, so your doctor may also remove some of the skin surrounding the spot to prevent this. [healthline.com]
The goals of treatment are to: cure the cancer preserve the appearance of your skin prevent the cancer from coming back The extent and depth of the melanoma guides your care plan. [mskcc.org]
Most people who have had a lentigo maligna, or melanoma in situ, removed will need another operation to try to prevent the melanoma from coming back at the original site. [esms-mohs.eu]
A high index of suspicion is often necessary to prevent a delayed or missed diagnosis of lentigo maligna. The second, more important contention is with Dr. Rose's discussion of biopsy techniques. [aafp.org]