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Lentigo Maligna: Clinical Presentation and Appropriate Management

Lentigo maligna (LM) is a type of melanoma in situ that has distinctive characteristics regarding epidemiology, risk factors and clinical features. In addition, LM has a potential to progress to an invasive tumor with potentially aggressive behavior: lentigo maligna melanoma (LMM). Overall, LM has a...

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Autores principales: Iznardo, Helena, Garcia-Melendo, Cristina, Yélamos, Oriol
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7671473/
https://www.ncbi.nlm.nih.gov/pubmed/33223843
http://dx.doi.org/10.2147/CCID.S224738
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author Iznardo, Helena
Garcia-Melendo, Cristina
Yélamos, Oriol
author_facet Iznardo, Helena
Garcia-Melendo, Cristina
Yélamos, Oriol
author_sort Iznardo, Helena
collection PubMed
description Lentigo maligna (LM) is a type of melanoma in situ that has distinctive characteristics regarding epidemiology, risk factors and clinical features. In addition, LM has a potential to progress to an invasive tumor with potentially aggressive behavior: lentigo maligna melanoma (LMM). Overall, LM has a very good prognosis, whereas LMM has the same prognosis as other invasive melanomas with similar Breslow thickness. LM/LMM represents a challenging entity not only regarding the diagnosis but also regarding the management. Diagnostic criteria are not well established, and there is an overlap of clinical, dermoscopic and pathological features with other benign pigmented skin lesions such as lentigines, pigmented actinic keratoses or macular seborrheic keratoses. LM/LMM’s common appearance within photodamaged skin makes lesion border identification difficult. Wide excisions are often required, but since LM/LMM typically appears on cosmetically sensitive areas such as the face, sometimes large excisions are not possible nor desirable. In this sense, specialized approaches have been developed such as margin-controlled surgery or image-guided treatment using reflectance confocal microscopy. Other treatments for LM such as cryosurgery, imiquimod, radiotherapy or photodynamic therapy have been proposed, although recurrence/persistence is common. The current manuscript reviews extensively the published data regarding the diagnosis, treatment and management of both complex entities LM and LMM.
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spelling pubmed-76714732020-11-20 Lentigo Maligna: Clinical Presentation and Appropriate Management Iznardo, Helena Garcia-Melendo, Cristina Yélamos, Oriol Clin Cosmet Investig Dermatol Review Lentigo maligna (LM) is a type of melanoma in situ that has distinctive characteristics regarding epidemiology, risk factors and clinical features. In addition, LM has a potential to progress to an invasive tumor with potentially aggressive behavior: lentigo maligna melanoma (LMM). Overall, LM has a very good prognosis, whereas LMM has the same prognosis as other invasive melanomas with similar Breslow thickness. LM/LMM represents a challenging entity not only regarding the diagnosis but also regarding the management. Diagnostic criteria are not well established, and there is an overlap of clinical, dermoscopic and pathological features with other benign pigmented skin lesions such as lentigines, pigmented actinic keratoses or macular seborrheic keratoses. LM/LMM’s common appearance within photodamaged skin makes lesion border identification difficult. Wide excisions are often required, but since LM/LMM typically appears on cosmetically sensitive areas such as the face, sometimes large excisions are not possible nor desirable. In this sense, specialized approaches have been developed such as margin-controlled surgery or image-guided treatment using reflectance confocal microscopy. Other treatments for LM such as cryosurgery, imiquimod, radiotherapy or photodynamic therapy have been proposed, although recurrence/persistence is common. The current manuscript reviews extensively the published data regarding the diagnosis, treatment and management of both complex entities LM and LMM. Dove 2020-11-13 /pmc/articles/PMC7671473/ /pubmed/33223843 http://dx.doi.org/10.2147/CCID.S224738 Text en © 2020 Iznardo et al. http://creativecommons.org/licenses/by-nc/3.0/ This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms (https://www.dovepress.com/terms.php).
spellingShingle Review
Iznardo, Helena
Garcia-Melendo, Cristina
Yélamos, Oriol
Lentigo Maligna: Clinical Presentation and Appropriate Management
title Lentigo Maligna: Clinical Presentation and Appropriate Management
title_full Lentigo Maligna: Clinical Presentation and Appropriate Management
title_fullStr Lentigo Maligna: Clinical Presentation and Appropriate Management
title_full_unstemmed Lentigo Maligna: Clinical Presentation and Appropriate Management
title_short Lentigo Maligna: Clinical Presentation and Appropriate Management
title_sort lentigo maligna: clinical presentation and appropriate management
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7671473/
https://www.ncbi.nlm.nih.gov/pubmed/33223843
http://dx.doi.org/10.2147/CCID.S224738
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