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Lentigo Maligna

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European Handbook of Dermatological Treatments

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Abstract

Lentigo maligna is a subtype of in situ melanoma appearing on chronically sun-exposed skin (mostly the face) of elderly patients. It manifests clinically as a flat macule with irregular contours and heterogeneous pigmentation. Lentigo maligna grows slowly over years in a radial pattern but may eventually progress with a vertical growth phase, thereby transforming into an invasive melanoma (lentigo maligna melanoma) that has potential for metastasis and lethal outcome. Accordingly, this lesion is nowadays regarded as an authentic melanoma in situ, rather than a premalignant condition. There are no prospective, randomized controlled studies evaluating the efficacy of the various treatment modalities applied for the treatment of lentigo maligna. Surgical excision with tumour-free margins is regarded as the best treatment modality, providing the best chances of clearance. Excision can be performed as traditional, one-step tumour ablation with predefined safety margins or, preferably, with margin-controlled techniques, such as staged excision or Mohs micrographic surgery, the latter methods achieving the highest cure rates. In the case of surgically unresectable tumours or in frail patients with severe comorbidities, alternative non-surgical (off-label) therapies can be applied, including radiotherapy and imiquimod, as monotherapy or in various combinations.

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  1. Department of Dermatology (Pav. R), Ed. Herriot Hospital Group, Hospices Civils de Lyon, Lyon, France

    Jean Kanitakis

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  1. Andreas Syggros Hospital, Athens State University, Athens, Greece

    Andreas D. Katsambas

  2. Research Center CSRMR, Marconi University, Rome, Roma, Italy

    Torello M. Lotti

  3. Andreas Syggros Hospital, Athens State University, Athens, Greece

    Clio Dessinioti

  4. Dermatoloy Unit, Livorno Hospital, Livorno, Italy

    Angelo Massimiliano D'Erme

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Kanitakis, J. (2023). Lentigo Maligna. In: Katsambas, A.D., Lotti, T.M., Dessinioti, C., D'Erme, A.M. (eds) European Handbook of Dermatological Treatments. Springer, Cham. https://doi.org/10.1007/978-3-031-15130-9_50

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