Display options
Cite
Juhász ML, Marmur ES. Reviewing Challenges in the Diagnosis and Treatment of Lentigo Maligna and Lentigo-Maligna Melanoma. Rare Cancers Ther. 2015;3:133-145doi: 10.1007/s40487-015-0012-9.
Juhász, M. L., & Marmur, E. S. (2015). Reviewing Challenges in the Diagnosis and Treatment of Lentigo Maligna and Lentigo-Maligna Melanoma. Rare cancers and therapy, 3133-145. https://doi.org/10.1007/s40487-015-0012-9
Juhász, Margit L W, and Marmur, Ellen S. "Reviewing Challenges in the Diagnosis and Treatment of Lentigo Maligna and Lentigo-Maligna Melanoma." Rare cancers and therapy vol. 3 (2015): 133-145. doi: https://doi.org/10.1007/s40487-015-0012-9
Juhász ML, Marmur ES. Reviewing Challenges in the Diagnosis and Treatment of Lentigo Maligna and Lentigo-Maligna Melanoma. Rare Cancers Ther. 2015;3:133-145. doi: 10.1007/s40487-015-0012-9. Epub 2015 Oct 15. PMID: 27182482; PMCID: PMC4837936.
Copy Download .nbib Format: NLM
Share it on

Rare Cancers Ther. 2015;3:133-145. doi: 10.1007/s40487-015-0012-9. Epub 2015 Oct 15.

Reviewing Challenges in the Diagnosis and Treatment of Lentigo Maligna and Lentigo-Maligna Melanoma.

Rare cancers and therapy

Margit L W Juhász, Ellen S Marmur

Affiliations

  1. Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY USA.
  2. Marmur Medical, New York, NY USA.

PMID: 27182482 PMCID: PMC4837936 DOI: 10.1007/s40487-015-0012-9

Abstract

Lentigo maligna (LM) and lentigo-maligna melanoma (LMM) are pigmented skin lesions that may exist on a continuous clinical and pathological spectrum of melanocytic skin cancer. LM is often described as a "benign" lesion and is accepted as a melanoma in situ; LM can undergo malignant transformation to particularly aggressive melanoma. LMM is an invasive melanoma that shares properties of LM, as well as exhibiting the metastatic potential of malignant melanoma. Unfortunately, LM/LMM diagnosis based on dermoscopy is rather ambiguous, and these lesions are often mistaken for junctional dysplastic nevi over sun-damaged skin, pigmented actinic keratosis, solar lentigo, or seborrheic keratosis. Diagnosis must be made on biopsy using distinct dermatopathologic features. These include a pagetoid appearance of melanocytes, melanocyte atypia, non-uniform pigmentation/distribution of melanocytes, and increased melanocyte density in a background of extensive photodamage. Advancements in immunohistochemical staining techniques, including soluble adenylyl cyclase (antibody R21), makes diagnosis easier and allows the definition of borders down to a single cell. After a pathologic diagnosis, there are a variety of treatment options, both surgical and non-surgical. Although surgical removal with a wide excision border is the preferred treatment due to decreased recurrence rates, experimental combination therapies are gaining popularity. However, no matter the treatment, LM/LMM carries a high recurrence rate, and patients must be monitored rigorously for recurrence as well as the appearance of additional skin lesions/cancers.

Keywords: Dermoscopy; Histopathology; Immunohistochemistry; Lentigo maligna; Lentigo-maligna melanoma; Non-surgical techniques; Pigmented actinic keratosis; Surgical excision

References

  1. Arch Dermatol. 2012 Feb;148(2):164-70 - PubMed
  2. Dermatol Surg. 2011 May;37(5):657-63 - PubMed
  3. J Am Acad Dermatol. 2011 Jan;64(1):113-8 - PubMed
  4. Int J Dermatol. 2010 May;49(5):482-91 - PubMed
  5. Arch Dermatol. 2012 Mar;148(3):335-44 - PubMed
  6. Arch Pathol Lab Med. 1982 Mar;106(3):121-5 - PubMed
  7. Arch Dermatol. 2011 Oct;147(10 ):1191-5 - PubMed
  8. Arch Dermatol. 2005 Apr;141(4):510-4 - PubMed
  9. Arch Facial Plast Surg. 2012 Nov;14(6):462 - PubMed
  10. Arch Dermatol. 1996 Nov;132(11):1297-302 - PubMed
  11. Arch Dermatol. 2003 May;139(5):595-604 - PubMed
  12. Br J Dermatol. 2014 Jan;170(1):52-8 - PubMed
  13. Ann Surg Oncol. 2009 Jun;16(6):1526-36 - PubMed
  14. Arch Pathol Lab Med. 2012 Dec;136(12):1558-64 - PubMed
  15. Arch Pathol Lab Med. 2011 Jul;135(7):838-41 - PubMed
  16. Plast Reconstr Surg. 2012 Feb;129(2):288e-299e - PubMed
  17. Br J Dermatol. 2012 Aug;167(2):280-7 - PubMed
  18. Am J Clin Dermatol. 2013 Dec;14(6):473-80 - PubMed
  19. J Am Acad Dermatol. 2013 Apr;68(4):647-53 - PubMed
  20. J Am Acad Dermatol. 2008 Jan;58(1):142-8 - PubMed
  21. Dermatol Surg. 2008 May;34(5):660-4 - PubMed
  22. Int J Dermatol. 2008 May;47(5):519-21 - PubMed
  23. Dermatol Surg. 2006 Apr;32(4):493-504 - PubMed
  24. J Am Acad Dermatol. 2012 Jul;67(1):60-8 - PubMed
  25. Clin Dermatol. 2014 Jan-Feb;32(1):88-93 - PubMed
  26. Melanoma Res. 1997 Feb;7(1):43-8 - PubMed
  27. Arch Dermatol. 2012 May;148(5):599-604 - PubMed
  28. Pigment Cell Melanoma Res. 2013 Mar;26(2):275-7 - PubMed
  29. J Am Acad Dermatol. 2013 Mar;68(3):452-8 - PubMed
  30. An Bras Dermatol. 2012 May-Jun;87(3):425-34 - PubMed
  31. Dermatol Surg. 2009 Apr;35(4):607-11; discussion 611-2 - PubMed
  32. J Surg Oncol. 2005 Aug 1;91(2):120-5 - PubMed
  33. Plast Reconstr Surg. 2009 Dec;124(6):1947-55 - PubMed
  34. Int J Dermatol. 2007 Apr;46(4):414-6 - PubMed
  35. Clin Dermatol. 2014 Jan-Feb;32(1):94-100 - PubMed
  36. Arch Dermatol. 2012 May;148(5):592-6 - PubMed
  37. J Dermatol. 2012 May;39(5):503-5 - PubMed
  38. Dermatol Surg. 2011 Sep;37(9):1210-28 - PubMed
  39. Br J Dermatol. 1987 Mar;116(3):303-10 - PubMed
  40. Can Med Assoc J. 1966 Oct 22;95(17):846-51 - PubMed
  41. Hautarzt. 1997 Aug;48(8):523-7 - PubMed
  42. J Am Acad Dermatol. 2003 May;48(5):679-93 - PubMed
  43. Br J Dermatol. 2013 Jun;168(6):1362-4 - PubMed
  44. Dermatol Surg. 2007 Sep;33(9):1099-101 - PubMed
  45. J Cutan Pathol. 2008 May;35(5):433-44 - PubMed
  46. Am J Clin Dermatol. 2005;6(3):151-64 - PubMed
  47. J Am Acad Dermatol. 1997 Nov;37(5 Pt 1):758-64 - PubMed
  48. Clin Dermatol. 2002 May-Jun;20(3):276-8 - PubMed
  49. J Am Acad Dermatol. 2012 Mar;66(3):438-44 - PubMed
  50. J Cutan Med Surg. 2012 Jul-Aug;16(4):245-9 - PubMed
  51. Am J Pathol. 1969 Apr;55(1):39-67 - PubMed
  52. J Am Acad Dermatol. 2010 Sep;63(3):499-506 - PubMed
  53. Arch Dermatol. 2008 Oct;144(10):1375-9 - PubMed
  54. Dermatol Surg. 2000 Oct;26(10):965-8 - PubMed
  55. Br J Dermatol. 2010 Dec;163(6):1212-7 - PubMed
  56. J Invest Dermatol. 2005 Oct;125(4):685-91 - PubMed
  57. J Plast Reconstr Aesthet Surg. 2014 Oct;67(10):1322-32 - PubMed
  58. Arch Dermatol. 1999 Jan;135(1):15-7 - PubMed
  59. Dermatol Surg. 2010 Mar;36(3):275-90 - PubMed
  60. Br J Dermatol. 2006 Oct;155(4):653-6 - PubMed

Publication Types