- Lentigo Maligna
- Is slowly evolving in-situ disease
- Hutchinson’s melanotic freckle
- Large irregular/asymmetric macular lesion
- Can be present for decades before invasion
- Blue-black flat lesion, or amelanotic
- Is slowly evolving in-situ disease
- Progression
- Lentigo Maligna Melanoma
- Invasive disease (5%) often occurs
- On the face
- In elderly with other signs of sun exposure
- Least malignant potential of melanomas
- Invasive disease (5%) often occurs
- Lentigo Maligna Melanoma
- Histology
- Diffuse continuous replacement of basal layer
- Spindle-shaped cells
- Lack of Pagetoid cells
- Diffuse continuous replacement of basal layer
- Diagnosis
- Excision or incisional biopsy
- If Lentigo Maligna Melanoma then treat as for Melanoma
- Excision or incisional biopsy
- Treatment
- Cosmetically challenging, may require 2 stage procedure
- High recurrence rates after excision
- Treatment options:
- Surgical Excision – ideal margin 5-10mm
- Radiotherapy
- Cryotherapy
- Imiquimod – not yet fully evaluated
- Cosmetically challenging, may require 2 stage procedure
- Prognosis
- Good, 5-20 yrs or longer
