Malignant lentigo and lentigo-melanoma: difficulties in differential diagnosis

Malishevskaya N.P.; Sokolova A.V.; Kohan M.M.

doi:https://doi.org/10.17116/klinderma20212005189

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

Malignant lentigo and lentigo-melanoma: difficulties in differential diagnosis

Authors:

Malishevskaya N.P., Sokolova A.V., Kohan M.M.

More about the authors

Journal: Russian Journal of Clinical Dermatology and Venereology. 2021;20(5): 89‑94

DOI: 10.17116/klinderma20212005189

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To cite this article:

Malishevskaya NP, Sokolova AV, Kohan MM. Malignant lentigo and lentigo-melanoma: difficulties in differential diagnosis. Russian Journal of Clinical Dermatology and Venereology. 2021;20(5):89‑94. (In Russ.)
https://doi.org/10.17116/klinderma20212005189

Подписка 2026 Клиническая дерматология и венерология (Russian Journal of Clinical Dermatology and Venereology)

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Abstract:

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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References:

Malignant neoplasms in Russia in 2018 (morbidity and mortality). Ed Kaprin A.D., Starinsky V.V., Petrova GV. M. FGBU MNIOI PA Gertsena, Ministry of health of Russia; 2019. (In Russ.).
Swetter SM, Boldrick JC, Jung SY, Egbert BM, Harvell JD. Increasing incidence of lentigo maligna melanoma subtypes: northern California and national trends 1990–2000. J. Invest. Dermatol. 2005;125(4):685-691. https://doi.org/10.1111/j.0022-202x.2005.23852.x
Toender A, Kjaer SK, Jensen A. Increased incidence of melanoma in situ in Denmark from 1997 to 2011: results from a nationwide population-based study. Melanoma Res. 2014;24(5):488-495. https://doi.org/10.1097/cmr.0000000000000092
Youl PH, Youlden DR, Baade PD. Changes in the site distribution of common melanoma subtypes in Queensland, Australia over time: implications for public health campaigns. Br J Dermatol. 2013;168(1):136-144. https://doi.org/10.1111/j.1365-2133.2012.11064.x
Mirzoyev SA, Knudson RM, Reed KB, et al. Incidence of lentigo maligna in Olmsted County, Minnesota, 1970 to 2007. J Am Acad Dermatol. 2014; 70(3):443-448. https://doi.org/10.1016/j.jaad.2013.11.008
Wu XC, Eide MJ, King J, et al. Racial and ethnic variations in incidence and survival of cutaneous melanoma in the United States, 1999–2006. J Am Acad Dermatol. 2011;65(5 suppl 1):26-37. https://doi.org/10.1016/j.jaad.2011.05.034
Connolly K, Nehal K, Busam K. Lentigo maligna and lentigo maligna melanoma: contemporary issues in diagnosis and management. Melanoma Manag. 2015;2(2):171-178. https://doi.org/10.2217/mmt.15.3
Guitera P, Collgros H, Madronio C, Goumas C, Mann G, Watts C, Pereira A, Armstrong B, Rachael M, Scolyer R, Menzies S, Thompson J, Cust A. The steadily growing problem of lentigo maligna and lentigo maligna melanoma in Australia: Population‐based data on diagnosis and management. Austalasian J. Dermatol. 2019;80(2):118-125. https://doi.org/10.1111/ajd.12928
Samaniego E, Redondo P. Lentigo maligna. Actas Dermosifiliogr. 2013; 104(9):757-775. https://doi.org/10.1016/j.ad.2012.05.006
Paek S, Sober A, Tsao H, Mihm M, Johnson T. Skin melanoma. Fitzpatrick’s Dermanologi in general medicine by Wolff K., Goldsmith L., Katz S., Gilchrest B., Paller A., Leffell D., editors. P. 1238-1264.
Ciocan D, Barbe C, Aubin F, et al. Distinctive features of melanoma and its management in elderly patients: a population-based study in France. JAMA Dermatol. 2013;149(10):1150-1157. https://doi.org/10.1001/jamadermatol.2013.706
Lesage C, Barbe C, Le Clainche A, Lesage FX, Bernard P, Grange F. Sex-related location of head and neck melanoma strongly argues for a major role of sun exposure in cars and photoprotection by hair. J Invest Dermatol. 2013;133(5):1205-1211. https://doi.org/10.1038/jid.2012.405
Gaudy-Marqueste C, Madjlessi N, Guillot B, Avril MF, Grob JJ. Risk factors in elderly people for lentigo maligna compared with other melanomas: a double case — control study. Arch Dermatol. 2009;145(4):418-423. https://doi.org/10.1001/archdermatol.2009.1
Kvaskoff M, Siskind V, Green AC. Risk factors for lentigo maligna melanoma compared with superficial spreading melanoma: a case — control study in Australia. Arch Dermatol. 2012;148(2):164-170. https://doi.org/10.1001/archdermatol.2011.291
Lee JH, Choi JW, Kim YS. Frequencies of BRAF and NRAS mutations are different in histological types and sites of origin of cutaneous melanoma: a meta-analysis. Br J Dermatol. 2011;164(4):776-784. https://doi.org/10.1111/j.1365-2133.2010.10185.x
Stadelmeyer E, Heitzer E, Resel M, Cerroni L, Wolf P, Dandachi N. The BRAF V600K mutation is more frequent than the BRAF V600E mutation in melanoma in situ of lentigo maligna type. J Invest Dermatol. 2014;134(2): 548-550. https://doi.org/10.1038/jid.2013.338
Kraft S, Granter SR. Molecular pathology of skin neoplasms of the head and neck. Arch Pathol Lab Med. 2014;138(6):759-787. https://doi.org/10.5858/arpa.2013-0157-ra
Mcguire LK, Disa JJ, Lee EH, Busam KJ, Nehal KS. Melanoma of the lentigo maligna subtype: diagnostic challenges and current treatment paradigms. Plast Reconstr Surg. 2012;129(2):288-299. https://doi.org/10.1097/prs.0b013e31823aeb72
Chervonaya LV. Pigmented skin tumors. M.: GEOTAR-Media; 2014. (In Russ.).
Stolz W, Schiffner R, Burgdorf WH. Dermatoscopy for facial pigmented skin lesions. Clin Dermatol. 2002;20(3):276-278. https://doi.org/10.1016/s0738-081x(02)00221-3
Pralong P, Bathelier E, Dalle S, Poulalhon N, Debarbieux S, Thomas L. Dermoscopy of lentigo maligna melanoma: report of 125 cases. Br J Dermatol. 2012;167(2):280-287. https://doi.org/10.1111/j.1365-2133.2012.10932.x
Keir J. Dermatoscopic features of cutaneous non-facial non-acral lentiginous growth pattern melanomas. Dermatol Pract Concept. 2014;4(1):77-82. https://doi.org/10.5826/dpc.0401a13
Robinson JK. Use of digital epiluminescence microscopy to help define the edge of lentigo maligna. Arch Dermatol. 2004;140(9):1095-1100. https://doi.org/10.1001/archderm.140.9.1095
Annessi G, Bono R, Abeni D. Correlation between digital epiluminescence microscopy parameters and histopathological changes in lentigo maligna and solar lentigo: A dermoscopic index for the diagnosis of lentigo maligna. J Am Acad Dermatol. 2017;76(2):234-243. https://doi.org/10.1016/j.jaad.2016.08.032
Newman J, Beal M, Schram SE, Lee PK. Mohs micrographic surgery for lentigo maligna and lentigo maligna melanoma using Mel-5 immunostaining: an update from the University of Minnesota. Dermatol Surg. 2013;39(12): 1794-1799. https://doi.org/10.1111/dsu.12356
Hendi A, Wada DA, Jacobs MA, et al. Melanocytes in non lesional sun-exposed skin: a multicenter comparative study. J Am Acad Dermatol. 2011; 65(6):1186-1193. https://doi.org/10.1016/j.jaad.2010.10.039
Black WH, Thareja SK, Blake BP, Chen R, Cherpelis BS, Glass LF. Distinction of melanoma in situ from solar lentigo on sun-damaged skin using morphometrics and MITF immunohistochemistry. Am J Dermatopathol. 2011;33(6):573-578. https://doi.org/10.1097/dad.0b013e3182093b13