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Giornale Italiano di Dermatologia e Venereologia 2009 April;144(2):149-55

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

Lentigo maligna: current concepts in diagnosis and management

Walling H. W.

Town Square Dermatology, Coralville, IA, USA

Lentigo maligna (LM) is a cutaneous malignancy with increasing incidence and significant risk of morbidity. Early diagnosis of LM requires a high index of suspicion for the often subtle atypical signs of pigmented lesions on sun-damaged skin. A variety of treatment options are available to the physician. Surgical options include simple excision and margin-control techniques such as staged excision and Mohs micrographic surgery. Tissue may be embedded vertically or en face, and processed as frozen or paraffin-embedded sections. Destructive options include radiotherapy, cryotherapy, curettage, and electro-destruction. Topical therapy may be appropriate in selected cases; immunotherapy with topical imiquimod may have advantages over other topical agents. The opportunity for curative therapy is maximized by surgical treatment. Margin-control surgery offers the highest cure rate while minimizing loss of normal tissue.