Malignant lentigo and lentigo-melanoma: difficulties in differential diagnosis

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The incidence of malignant lentigo and lentigo-melanoma is increasing worldwide, as evidenced by studies in the United States, Australia, Denmark and Russia. Diagnosis and treatment of these neoplasms cause difficulties due to its frequent localization on cosmetically sensitive areas of the skin damaged by chronic solar radiation. With malignant lentigo (limited precancerous melanosis of Dubreus) there is a high risk of malignancy (in 50–74% of cases) with the development of lentigo-melanoma on its background. Lentigo-melanoma must be differentiated from malignant lentigo, solar lentigo, pigmented actinic keratosis, pigmented basal cell carcinoma, and seborrheic keratosis. Dermatoscopic examination improves the accuracy of early neoplasm diagnosis that is especially important when localizing them in cosmetically sensitive areas of the face. Unique dermatoscopic picture of lentigo-melanoma on the facial skin are hyperpigmentation of follicular openings, annular-granular pattern of gray dots surrounding follicles, diamond-shaped structures around hair follicle openings, and obliteration of follicular openings in more invasive lesions. Since hyperplasia of melanocytes often develops in the skin chronically exposed to sunlight, histological verification of lentigo-melanoma in such areas can cause significant difficulties.

Keywords:

malignant lentigo

lentigo-melanoma

diagnostics of lentigo-melanoma

dermatoscopy of lentigo-melanoma

Authors:

Malishevskaya N.P.

Ural Research Institute of Dermatovenerology and immunopathology

Sokolova A.V.

Ural Research Institute of Dermatovenerology and immunopathology

Kohan M.M.

Ural Research Institute of Dermatovenerology and immunopathology

SPIN RSCI: 3470-9306
Scopus AuthorID: 6508188327
ORCID: 0000-0001-6353-6644

Received:

07.10.2020

Accepted:

23.07.2021

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