Lentigo maligna can be defined as ''melanoma in situ,'' histologically showing atypical melanocytes confined to the epidermis and appendageal epithelium. The clinical appearance of lentigo maligna features inhomogeneously pigmented, polycyclic macules arising predominantly in sun-exposed areas in elderly whites (Figure, left). The lesions tend to enlarge slowly in a horizontal direction. They may, within years, give rise to metastatic disease.
Complete but conservative excision should be the treatment of choice to achieve accurate microstaging and to reduce the likelihood of recurrence.
In patients showing hazardous health conditions due to systemic diseases, malformations, or advanced age, or presenting with large lentigo maligna lesions in cosmetically precarious locations that require flaps or skin grafts, surgical excision may be not be possible. We performed carbon dioxide laser vaporization of histopathologically verified lentigo maligna lesions in four selected patients (Table).
Materials and Methods.
Carbon Dioxide Laser. The carbon dioxide laser emits invisible infrared light