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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...

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Autores principales: 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
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mattioli 1885 2023
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.
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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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