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January 1993

Management of Lentigo Maligna

Author Affiliations

Rochester General Hosptial 1425 Portland Ave Rochester, NY 14621

Arch Dermatol. 1993;129(1):46. doi:10.1001/archderm.1993.01680220058014

To the Editor.—  The article by Dr Kelly in the May 1992 issue of the Archives was a very interesting case report, suggesting that management of lentigo maligna by careful observation at 6- to 12-month intervals might not prevent evolution to life-threatening lentigo maligna melanoma.1 It brought to mind a remarkable case that was reported 10 years ago, wherein 14 lesions of evolving lentigo maligna melanoma were resected from the left cheek of a woman in her 50s over a period of 9 years.2That patient presented for cosmetic surgery for a 3-mm pigmented lesion that was diagnosed histologically as lentigo maligna. Although margins were negative, a 12-mm lentigo maligna in the same region was resected 10 months later. In spite of constant surveillance, and surgery before any subsequent lesion attained 1 cm in diameter, four separate invasive melanomas developed, eventuating in a 7-mm amelanotic melanoma 9 years

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