Lentiginous melanoma (lentigo maligna and lentigo maligna melanoma) in Australia: clinicopathological characteristics, management and recurrence rates after 10‐year follow‐up at a tertiary centre. (3rd March 2021)

• Record Type: Journal Article
• Authors: Collgros, H.; Rodriguez‐Lomba, E.; Regio Pereira, A.; Lo, S.N.; Scolyer, R.A.; Guitera, P.
• Is Part Of: Journal of the European Academy of Dermatology and Venereology. Volume 35:Number 6(2021)
• Page Start: 1315
• Page End: 1322
• Publication Date: 2021-03-03
• Subjects: Dermatology -- Periodicals; Sexually transmitted diseases -- Periodicals; 616.5
• DOI: 10.1111/jdv.17135
• Languages: English
• ISSNs: 0926-9959

Abstract

Abstract: Background: Lentiginous melanoma or lentigo maligna is a slow‐growing type of melanoma frequently arising in sun‐damaged skin and often first diagnosed in the elderly. Few studies report long‐term follow‐up. Objectives: To define characteristics of lentiginous melanoma in situ (LM) and invasive lentiginous melanoma (LMM) in Australian patients managed at a tertiary centre and describe local recurrence or treatment failure rates after long‐term follow‐up. Methods: Retrospective single‐centre study of LM/LMM patients evaluated between January 2005 and March 2007. Medical and photographic records were reviewed. Results: One hundred two patients were included, with a total of 117 lesions (70 LM and 47 LMM). Seventy‐nine were new primary LM/LMM, and 38 were recurrences. Primary cases were mostly pigmented (71%), while 77% of recurrent cases were partially pigmented/light brown or amelanotic. The margins were clinically ill‐defined in the majority of cases (64% of primary cases and 94% of recurrent cases). Dermoscopy of the primary LM/LMM showed either classic 'common' melanoma features (33%) or classic LM/LMM features (41%), while 95% of recurrent cases had no features for melanoma or LM/LMM. Primary cases that were initially excised (113, 97%) had mean histopathological clear margins of 4.9 mm (range 0.1–22 mm). The median follow‐up time was 7.5 years (95% CI 5.2–10.0) with more than 10‐year follow‐up in 32% and 5–10 years in 24% of patients. There were 44 (38%) recurrences over the entire follow‐up period. Half of the patients who recurred did so within the first 3.8 years after the first treatment. Conclusion: LM/LMM often recur late and are clinically subtle; therefore, careful monitoring and long‐term follow‐up are required. Abstract : Linked Commentary: P. Pietkiewicz J Eur Acad Dermatol Venereol 2021; 35: 1246–1247. https://doi.org/10.1111/jdv.17291 .