Lentigo Maligna Melanoma

Excerpt

Lentigo maligna, a subtype of melanoma, typically presents as an irregular brown macule on chronically sun-damaged skin, most often affecting the head and neck region. Hutchinson first described this lesion in 1890, referring to it as “Hutchinson’s melanotic freckle.” Throughout much of the early 20th century, lentigo maligna was considered benign, infectious, or precancerous due to its slow progression, leading to various names, eg, “junctional nevus,” “infective senile freckles,” and “circumscribed precancerous melanosis.” Widespread recognition of its malignant nature emerged in the late 1970s and 1980s, driven by pivotal research conducted by Silvers, Ackerman, and colleagues.

Current definitions classify lentigo maligna as melanoma in situ (MIS) occurring on chronically sun-damaged skin. By definition, lentigo maligna remains confined to the epidermis. Once the lesion becomes invasive, the diagnosis changes to lentigo maligna melanoma (LMM) (see Image. Lentigo Maligna Melanoma). An in-depth knowledge of the distinguishing features and distinctive therapeutic approaches of lentigo maligna and LMM is essential to ensure accurate diagnosis, optimal treatment planning, and improved patient outcomes.