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May 1992

Following Lentigo Maligna May Not Prevent the Development of Life-Threatening Melanoma

Author Affiliations

From the Dermatology Unit and Monash University Department of Medicine, Alfred Hospital, Melbourne, Australia.

Arch Dermatol. 1992;128(5):657-660. doi:10.1001/archderm.1992.01680150087012

• Background.—  Management of lentigo maligna (Hutchinson's melanotic freckle, in situ lentigo maligna melanoma) by regular observation relies on the detection of invasive melanoma before it has developed significant life-threatening potential. Recent studies indicate that lentigo maligna melanoma does not have a better prognosis than other forms of melanoma.

Observations.—  A case is reported of an amelanotic lentigo maligna that evolved from a macular lesion to a deeply invasive, amelanotic, lentigo maligna melanoma within 6 months. The melanoma was Clark level IV and measured 3.0 mm in maximum tumor thickness.

Conclusions.—  Observation of lentigo maligna at 6-month intervals would not seem to be sufficiently reliable in detecting the development of invasive lentigo maligna melanoma before it becomes a life-threatening disease. Early surgical excision is the treatment of choice.(Arch Dermatol. 1992;128:657-660)

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