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Delphi Consensus Among International Experts on the Diagnosis, Management, and Surveillance for Lentigo Maligna
INTRODUCTION: Melanoma of the lentigo maligna (LM) type is challenging. There is lack of consensus on the optimal diagnosis, treatment, and follow-up. OBJECTIVES: To obtain general consensus on the diagnosis, treatment, and follow-up for LM. METHODS: A modified Delphi method was used. The invited pa...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Mattioli 1885
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10412039/ https://www.ncbi.nlm.nih.gov/pubmed/37403983 http://dx.doi.org/10.5826/dpc.1303a244 |
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author | Longo, Caterina Navarrete-Dechent, Cristian Tschandl, Philipp Apalla, Zoe Argenziano, Giuseppe Braun, Ralph P. Bataille, Veronique Cabo, Horacio Hoffmann-Wellhenhof, Rainer Forsea, Ana Maria Garbe, Claus Guitera, Pascale Raimond, Karls Marghoob, Ashfaq A. Malvehy, Josep del Marmol, Veronique Moreno, David Nehal, Kishwer S. Nagore, Eduardo Paoli, John Pellacani, Giovanni Peris, Ketty Puig, Susana Soyer, H. Peter Swetter, Susan Stratigos, Alexander Stolz, Wilhelm Thomas, Luc Tiodorovic, Danica Zalaudek, Iris Kittler, Harald Lallas, Aimilios |
author_facet | Longo, Caterina Navarrete-Dechent, Cristian Tschandl, Philipp Apalla, Zoe Argenziano, Giuseppe Braun, Ralph P. Bataille, Veronique Cabo, Horacio Hoffmann-Wellhenhof, Rainer Forsea, Ana Maria Garbe, Claus Guitera, Pascale Raimond, Karls Marghoob, Ashfaq A. Malvehy, Josep del Marmol, Veronique Moreno, David Nehal, Kishwer S. Nagore, Eduardo Paoli, John Pellacani, Giovanni Peris, Ketty Puig, Susana Soyer, H. Peter Swetter, Susan Stratigos, Alexander Stolz, Wilhelm Thomas, Luc Tiodorovic, Danica Zalaudek, Iris Kittler, Harald Lallas, Aimilios |
author_sort | Longo, Caterina |
collection | PubMed |
description | INTRODUCTION: Melanoma of the lentigo maligna (LM) type is challenging. There is lack of consensus on the optimal diagnosis, treatment, and follow-up. OBJECTIVES: To obtain general consensus on the diagnosis, treatment, and follow-up for LM. METHODS: A modified Delphi method was used. The invited participants were either members of the International Dermoscopy Society, academic experts, or authors of published articles relating to skin cancer and melanoma. Participants were required to respond across three rounds using a 4-point Likert scale). Consensus was defined as >75% of participants agreeing/strongly agreeing or disagreeing/strongly disagreeing. RESULTS: Of the 31 experts invited to participate in this Delphi study, 29 participants completed Round 1 (89.9% response rate), 25/31 completed Round 2 (77.5% response rate), and 25/31 completed Round 3 (77.5% response rate). Experts agreed that LM diagnosis should be based on a clinical and dermatoscopic approach (92%) followed by a biopsy. The most appropriate primary treatment of LM was deemed to be margin-controlled surgery (83.3%), although non-surgical modalities, especially imiquimod, were commonly used either as alternative off-label primary treatment in selected patients or as adjuvant therapy following surgery; 62% participants responded life-long clinical follow-up was needed for LM. CONCLUSIONS: Clinical and histological diagnosis of LM is challenging and should be based on macroscopic, dermatoscopic, and RCM examination followed by a biopsy. Different treatment modalities and follow-up should be carefully discussed with the patient. |
format | Online Article Text |
id | pubmed-10412039 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Mattioli 1885 |
record_format | MEDLINE/PubMed |
spelling | pubmed-104120392023-08-10 Delphi Consensus Among International Experts on the Diagnosis, Management, and Surveillance for Lentigo Maligna Longo, Caterina Navarrete-Dechent, Cristian Tschandl, Philipp Apalla, Zoe Argenziano, Giuseppe Braun, Ralph P. Bataille, Veronique Cabo, Horacio Hoffmann-Wellhenhof, Rainer Forsea, Ana Maria Garbe, Claus Guitera, Pascale Raimond, Karls Marghoob, Ashfaq A. Malvehy, Josep del Marmol, Veronique Moreno, David Nehal, Kishwer S. Nagore, Eduardo Paoli, John Pellacani, Giovanni Peris, Ketty Puig, Susana Soyer, H. Peter Swetter, Susan Stratigos, Alexander Stolz, Wilhelm Thomas, Luc Tiodorovic, Danica Zalaudek, Iris Kittler, Harald Lallas, Aimilios Dermatol Pract Concept Original Article INTRODUCTION: Melanoma of the lentigo maligna (LM) type is challenging. There is lack of consensus on the optimal diagnosis, treatment, and follow-up. OBJECTIVES: To obtain general consensus on the diagnosis, treatment, and follow-up for LM. METHODS: A modified Delphi method was used. The invited participants were either members of the International Dermoscopy Society, academic experts, or authors of published articles relating to skin cancer and melanoma. Participants were required to respond across three rounds using a 4-point Likert scale). Consensus was defined as >75% of participants agreeing/strongly agreeing or disagreeing/strongly disagreeing. RESULTS: Of the 31 experts invited to participate in this Delphi study, 29 participants completed Round 1 (89.9% response rate), 25/31 completed Round 2 (77.5% response rate), and 25/31 completed Round 3 (77.5% response rate). Experts agreed that LM diagnosis should be based on a clinical and dermatoscopic approach (92%) followed by a biopsy. The most appropriate primary treatment of LM was deemed to be margin-controlled surgery (83.3%), although non-surgical modalities, especially imiquimod, were commonly used either as alternative off-label primary treatment in selected patients or as adjuvant therapy following surgery; 62% participants responded life-long clinical follow-up was needed for LM. CONCLUSIONS: Clinical and histological diagnosis of LM is challenging and should be based on macroscopic, dermatoscopic, and RCM examination followed by a biopsy. Different treatment modalities and follow-up should be carefully discussed with the patient. Mattioli 1885 2023-07-01 /pmc/articles/PMC10412039/ /pubmed/37403983 http://dx.doi.org/10.5826/dpc.1303a244 Text en ©2023 Longo et al. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (BY-NC-4.0), https://creativecommons.org/licenses/by-nc/4.0/, which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original authors and source are credited. |
spellingShingle | Original Article Longo, Caterina Navarrete-Dechent, Cristian Tschandl, Philipp Apalla, Zoe Argenziano, Giuseppe Braun, Ralph P. Bataille, Veronique Cabo, Horacio Hoffmann-Wellhenhof, Rainer Forsea, Ana Maria Garbe, Claus Guitera, Pascale Raimond, Karls Marghoob, Ashfaq A. Malvehy, Josep del Marmol, Veronique Moreno, David Nehal, Kishwer S. Nagore, Eduardo Paoli, John Pellacani, Giovanni Peris, Ketty Puig, Susana Soyer, H. Peter Swetter, Susan Stratigos, Alexander Stolz, Wilhelm Thomas, Luc Tiodorovic, Danica Zalaudek, Iris Kittler, Harald Lallas, Aimilios Delphi Consensus Among International Experts on the Diagnosis, Management, and Surveillance for Lentigo Maligna |
title | Delphi Consensus Among International Experts on the Diagnosis, Management, and Surveillance for Lentigo Maligna |
title_full | Delphi Consensus Among International Experts on the Diagnosis, Management, and Surveillance for Lentigo Maligna |
title_fullStr | Delphi Consensus Among International Experts on the Diagnosis, Management, and Surveillance for Lentigo Maligna |
title_full_unstemmed | Delphi Consensus Among International Experts on the Diagnosis, Management, and Surveillance for Lentigo Maligna |
title_short | Delphi Consensus Among International Experts on the Diagnosis, Management, and Surveillance for Lentigo Maligna |
title_sort | delphi consensus among international experts on the diagnosis, management, and surveillance for lentigo maligna |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10412039/ https://www.ncbi.nlm.nih.gov/pubmed/37403983 http://dx.doi.org/10.5826/dpc.1303a244 |
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