Abstract
Lentigo Maligna (LM) represents in situ melanoma that develops in chronically sun-damaged skin—often on the face of elderly Caucasian patients. Most LMs present as asymmetric brown-black macules or patches with variegated color and irregular borders. Diagnosis of LM is often delayed due to its slow growth and the fact that many benign but similar appearing lesions also develop in these patients. Various techniques can be used to biopsy a concerning lesion. When LM is diagnosed on a small incisional biopsy and significant clinically evident lesion remains, the practitioner must be mindful of possible sampling error since 4–16 % of LM lesions have been found to contain an invasive component.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Chang AE, Karnell LH, Menck HR. The National Cancer Data Base report on cutaneous and noncutaneous melanoma: a summary of 84,836 cases from the past decade. The American College of Surgeons Commission on Cancer and the American Cancer Society. Cancer. 1998;83(8):1664–78.
Toender A, Kjær SK, Jensen A. Increased incidence of melanoma in situ in Denmark from 1997 to 2011: results from a nationwide population-based study. Melanoma Res. 2014;24(5):488–95.
Tiodorovic-Zivkovic D, Argenziano G, Lallas A, Thomas L, Ignjatovic A, Rabinovitz H, Moscarella E, Longo C, Hofmann-Wellenhof R, Zalaudek I. Age, gender, and topography influence the clinical and dermoscopic appearance of lentigo maligna. J Am Acad Dermatol. 2015;72(5):801–8.
Higgins II HW, Lee K, Galan A, Leffell DJ. Melanoma in situ: Part I. Epidemiology, screening, and clinical features. J Am Acad Dermatol. 2015;73(2):181–90.
Jaimes N, Marghoob AA, Rabinovitz H, Braun RP, Cameron A, Rosendahl C, Canning G, Keir J. Clinical and dermoscopic characteristics of melanomas on nonfacial chronically sun-damaged skin. J Am Acad Dermatol. 2015;72(6):1027–35.
Rigel DS, Friedman RJ, Kopf AW, Polsky D. ABCDE--an evolving concept in the early detection of melanoma. Arch Dermatol. 2005;141(8):1032–4.
Paraskevas LR, Halpern AC, Marghoob AA. Utility of the Wood’s light: five cases from a pigmented lesion clinic. Br J Dermatol. 2005;152(5):1039–44.
Mendes G, Maloney M, Bordeaux J. To scoop or not to scoop: the diagnostic and therapeutic utility of the scoop-shave biopsy for pigmented lesions. Dermatol Surg. 2014;40(10):1077–83.
Zager JS, Hochwald SN, Marzban SS, Francois R, Law KM, Davis AH, Messina JL, Vincek V, Mitchell C, Church A, Copeland EM, Sondak VK, Grobmyer SR. Shave biopsy is a safe and accurate method for the initial evaluation of melanoma. J Am Coll Surg. 2011;212(4):454–60.
Somach SC, Taira JW, Pitha JV, Everett MA. Pigmented lesions in actinically damaged skin. Histopathologic comparison of biopsy and excisional specimens. Arch Dermatol. 1996;132(11):1297–302.
Karimipour DJ, Schwartz JL, Wang TS, Bichakjian CK, Orringer JS, King AL, Huang CC, Johnson TM. Microstaging accuracy after subtotal incisional biopsy of cutaneous melanoma. J Am Acad Dermatol. 2005;52(5):798–802.
Agarwhal-Antal N, Bowen GM, Gerwels JW. Histologic evaluation of lentigo maligna with permanent sections: implications regarding current guidelines. J Am Acad Dermatol. 2002;47(5):743–8.
Gardner KH, Hill DE, Wright AC, Brewer JD, Arpey CJ, Otley CC, Roenigk RK, Baum CL. Upstaging from melanoma in situ to invasive melanoma on the head and neck after complete surgical resection. Dermatol Surg. 2015;41(10):1122–5.
National Comprehensive Cancer Network. Melanoma (Version 2.2016). http://www.nccn.org/professionals/physician_gls/PDF/melanoma.pdf. Accessed 16 Mar 2016.
Bichakjian CK, Halpern AC, Johnson TM, Foote Hood A, Grichnik JM, Swetter SM, Tsao H, Barbosa VH, Chuang TY, Duvic M, Ho VC, Sober AJ, Beutner KR, Bhushan R, Smith Begolka W, American Academy of Dermatology. Guidelines of care for the management of primary cutaneous melanoma. American Academy of Dermatology. J Am Acad Dermatol. 2011;65(5):1032–47.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Sullivan, A., Wang, T. (2017). Clinical Diagnosis. In: Nehal, K., Busam, K. (eds) Lentigo Maligna Melanoma. Springer, Cham. https://doi.org/10.1007/978-3-319-43787-3_3
Download citation
DOI: https://doi.org/10.1007/978-3-319-43787-3_3
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-43785-9
Online ISBN: 978-3-319-43787-3
eBook Packages: MedicineMedicine (R0)