Survey of U.K. current practice in the treatment of lentigo maligna

Abstract

This survey highlights that a significant proportion of U.K. dermatologists is managing small numbers of LMs each year. On the basis of this current practice and the data in the literature on the recurrence rates for the different modalities, we propose an algorithm for treatment options. The survey, however, showed no consensus between dermatologists regarding surgical margins for excision, which is reflected in the literature; further studies to establish this are required.

Trends for in situ and Invasive Melanoma in Queensland, Australia, 1982–2002

“…In particular, lentigo maligna are mainly a disease of the elderly (peak incidence is in the 8th and 9th decades), in whom they are sometimes treated conservatively and in whom the diagnosis might not have been confirmed by histology [8], especially during the 1980s and early 1990s. There were between 100 and 130 cases of lentigo maligna reported to the QCR each year between 1982 and 2002.…”

Surgical Margins for Lentigo Maligna and Lentigo Maligna Melanoma

“…5,6 In LM, destructive modalities such as cryotherapy, electrodessication and curettage, laser surgery, radiotherapy, and fluorouracil have high recurrence rates of 20% to 100%. 5,7,8 Surgical excision of LM has the advantage of treating deep periadnexal melanocytes, detecting unsuspected invasive LMM, and permitting histologic assessment of the margins for atypical melanocytes, which commonly extend beyond the clinically apparent border. 9 However, the clinical margins of LM and LMM are often poorly defined and may also be masked by ephelides, pigmented actinic keratoses, lentigines, nevi, and seborrheic keratoses.…”

Histopathologic Recognition of Involved Margins of Lentigo Maligna Excised by Staged Excision

“…1,2 These lesions occur predominantly on the sun-exposed skin of the head and neck in elderly patients and have an unpredictable clinical courselesions may remain indolent for years before becoming invasive. 3 Once invasion occurs, LMM has a prognosis similar to other subtypes of malignant melanoma.…”