Diagnosis and management of lentigo maligna: a review

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Lentigo maligna is a melanocytic neoplasm occurring on sun-exposed skin, usually on the head and neck, of middle-aged and elderly patients. It is thought to represent the in situ phase of lentigo maligna melanoma. The ill-defined nature and potentially large size of lesions can pose significant diagnostic and treatment challenges. The goal of therapy is to cure the lesions in order to prevent development of invasive disease, and surgical excision is the treatment of choice to achieve clear histological margins. Nonsurgical treatment modalities have been reported; however, evidence is lacking to support their use. Age, general health, and comorbidities need to be taken into account when deciding the right treatment modality for each individual patient.

Keywords: lentigo maligna, diagnosis, immunohistochemistry, histopathology, Mohs micrographic surgery, staged excision, imiquimod.

Abbreviations: AJCC, American Joint Committee on Cancer; IHC, immunohistochemical; MART, melanoma antigen recognized by T cells, also known as Melan A; MiTF, microophthalmia transcription factor; MMS, Mohs micrographic surgery; RCM, reflectance confocal microscopy; sAC, soluble adenylyl cyclase.

Citation: Kasprzak JM, Xu YG. Diagnosis and management of lentigo maligna: a review. Drugs in Context 2015; 4: 212281. DOI: 10.7573/dic.212281

Contributions: YGX had full access to all of the data in the review and takes responsibility for the integrity of the data and the accuracy of the data analysis. Study concept and design: YGX, JMK; acquisition, analysis, or interpretation of data: JMK, YGX; drafting of the manuscript: JMK, YGX; critical revision of the manuscript for important intellectual content: YGX; administrative, technical, or material support: YGX; study supervision: YGX.

Potential conflicts of interest: The International Committee of Medical Journal Editors’ (ICMJE) Potential Conflicts of Interests forms for the authors are available for download at: http://www.drugsincontext.com/wp-content/uploads/2015/05/dic.212281.pdf. The authors declare no conflicts of interest.

Funding declaration: None to declare.

Copyright: Copyright © 2015 Kasprzak JM, Xu YG. Distributed under the terms of the Creative Commons License Deed CC BY NC ND 3.0 which allows anyone to copy, distribute, and transmit the article provided it is properly attributed in the manner specified below. No commercial use without permission.

Correct attribution: Copyright © 2015 Kasprzak JM, Xu YG. http://dx.doi.org/10.7573/dic.212281. Published by Drugs in Context under Creative Commons License Deed CC BY NC ND 3.0.

Article URL: http://www.drugsincontext.com/diagnosis-management-lentigo-maligna-review

Correspondence: Yaohui Gloria Xu, MD, PhD, Department of Dermatology, University of Wisconsin School of Medicine and Public Health, 1 S. Park Street, 7th floor, Madison, Wisconsin 53715, USA. yxu@dermatology.wisc.edu

Provenance: Invited; externally peer reviewed

Submitted: 29 April 2015; Accepted, subject to peer review: 12 May 2015; Peer review comments to author: 12 May 2015; Published: 29 May 2015

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