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At least 19 recordsLinked to original sources
PubMed1979

Treatment of lentigo maligna and lentigo maligna melanoma.

The results of treatment of 42 cases of lentigo maligna and 16 of lentigo maligna melanoma at the New York University Medical Center was reviewed. The recurrence rate after surgical excision of 22 lesions of lentigo maligna was 9% (2/22), but after treatment of 20 such lesions with destructive techniques (X rays, curettage-electrodesiccation, cryosurgery), it was 35% (7/20). Of 11 cases of lentigo maligna melanoma that were excised, none recurred locally, but fatal metastases ensued in one case. Five patients who were eventually classified as having lentigo maligna melanomas had been treated by destructive techniques. In four of them there were local recurrences and in two, metastases as well; the fifth patient had metastases without local recurrence. On the basis of this review of these 58 cases, we conclude that surgical excision and careful histologic study of step sections through the entire lesion insure accurate diagnosis and provide the highest cure rates for lentigo maligna and lentigo maligna melanoma.

Adult↗
PubMed1976

Fluorescence-microscopic investigations of pigment cells of lentigo maligna (melanosis circumscripta praeblastomatosa Dubreuilh) and lentigo maligna melanoma.

With fluorescence-histochemical methods (formalin-induced fluorescence), the different stadia of development of lentigo maligna (Morbus Dubreuih) and lentigo maligna melanoma were investigated. In this way, the special stadia can be clearly characterized using the fluorescence-microscope. In the earliest stadium of malignancy, only the pigment-cells of the basal part of the epidermis seem to be numerous. At this time, these cells are mainly arranged as palisades in the basal layer, and their strongest dendrites are usually directed towards the corneal layer. As the malignancy progresses, the pigment-cells are arranged in several layers in the basal epidermis. In this case, polymorphism of the cells is obvious and their dendrites spread in all directions. A further stadium shows pathological alterations resembling a lentigo with long rete ridges. The atypical cells cluster together into the so-called pseudonests, predominantly at the tips of these rete ridges. With the fluorescence-microscope, dendrites are seldom visible here. In the stadium of tumorous growth, all above-described alterations of the epidermis in lentigo maligna are no longer detectable. Malignant cells in the dermis, which form as a tumor mode, seldom show dendrites. These cells are mainly round or oval-shaped; at best there are some spindle cells in certain areas of the tumor. The epidermis covering the tumor node is infiltrated by some tumor cells but the characteristic alterations as described above for the various stadia of lentigo maligna are no longer visible. Even fluorescence-microscopically, a tumor node of lentigo maligna does not seem to be different from a primary nodular melanoma or a tumor node of a superficial spreading melanoma, if the flat parts of the tumors are not considered in the diagnosis.

Humans↗
PubMed1990

[The subclinical portion in the periphery of lentigo maligna and lentigo maligna melanoma].

Lentigo maligna is a precancerosis or a melanoma in situ, whose level of malignancy has not yet been definitively clarified. Recurrences are not rare after excision, even when an ample safe margin is observed. One reason for this is the existence of a subclinical ramification in the marginal area of the lentigo maligna. Such subclinical ramifications were investigated by means of excision with histological monitoring of the margins by the paraffin section technique. There was a clear relationship between the frequency of these ramifications and the clinical safe margin left in 64 excisions. With the aid of parametric evaluation methods the distribution of the subclinical portion referred to the distance from the clinical margin could be determined with a special formula. If an invasion, in the form of a lentigo maligna melanoma had already taken place, then the subclinical portion within the marginal area was significantly more extensive. For the treatment of lentigo maligna, and especially of lentigo maligna melanoma, we therefore recommend excision with histological monitoring of the margins. There were no local recurrences within an average follow-up period of about 2 1/2 years.

Adult↗
PubMed1992

Reticulated black solar lentigo ('ink spot' lentigo).

BACKGROUND AND DESIGN: Pigmented lesions that are black and have an irregular outline are often considered suspicious for melanoma; however, these features may be seen in benign lesions. The reticulated black solar lentigo is such a lesion and is described in a clinicopathologic study of nine lesions in eight patients. RESULTS: The "ink spot" lentigo is distinguished clinically by its color and wiry or beaded, markedly irregular outline. It has a reticulated pattern and most resembles a spot of ink on the skin. In this series of patients, the lesions were limited to sun-exposed areas of the body and had a distribution pattern similar to that of solar lentigines. Although all the patients were of Celtic ancestry and had numerous solar lentigines, they usually had only one black lentigo (range, one to four; mean, 1.6; median, one). Histologic evaluation, including electron microscopy and dopa-incubated vertical sections, demonstrated lentiginous hyperplasia of the epidermis, marked hyperpigmentation of the basal layer with "skip" areas that involved the rete ridges, and a minimal increase in the number of melanocytes. CONCLUSIONS: Because of their dark color, irregular border, and limited number, reticulated black solar lentigines were of concern to patients and primary care physicians. However, the characteristic features of these lesions allow one to make the clinical diagnosis of a benign lentigo.

Adult↗
PubMed1978

Lentigo maligna and lentigo maligna melanoma. Recognition and treatment.

Lentigo maligna is the preinvasive stage of lentigo maligna melanom, which is a specific type of cutaneous malignant melanom found almost exclusively in the head and neck area. The distinguishing features and the biological behavior of this disease are discussed. Emphasis is placed on early diagnosis by clinical differentiation from other pigmented lesions and by biopsy specimen. Treatment by adequate surgical removal with appropriate reconstruction is discussed and illustrated with case reports.

Aged↗
PubMed1987

The risk of progression of lentigo maligna to lentigo maligna melanoma.

An analysis is presented which estimates the risk of progression of lentigo maligna (LM) to lentigo maligna melanoma (LMM) in U.S. whites using three data sources: the Health and Nutrition Examination Survey I for estimation of the age-specific prevalence of LM; the Surveillance, Epidemiology, and End Results Program for estimation of the age-specific incidence of melanoma; and the data from three melanoma registries for estimation of the age-specific case fraction of LMM among all invasive melanomas. The risk varies with age and is likely to be greater than estimated here for patients who present themselves for evaluation of changes in a lesion of LM. Our analysis suggests that the risk of progression from LM to LMM is substantially lower than is commonly believed.

Adolescent↗
PubMed1992

Following lentigo maligna may not prevent the development of life-threatening melanoma.

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.

Follow-Up Studies↗
PubMed1979

A retrospective histological study of 669 cases of primary cutaneous malignant melanoma in clinical stage I. The consequences of a reclassification of the original group of lentigo maligna melanomas.

A selected series of primary malignant melanoma of the skin, clinical stage I, was originally classified according to Clark's system. The consistency of this classification was tested by two Brisbane pathologists who indicated that we had misinterpreted some cases of superficial spreading malignant melanoma as lentigo maligna melanoma. We have therefore reclassified the original group of 86 lentigo maligna melanomas. This resulted in a total series of 37 (5.5%) lentigo maligna melanomas, 301 (45%) superficial spreading malignant melanomas, 194 (29%) nodular malignant melanomas (unchanged) and 137 (20.5%) unclassifiable malignant melanomas. The diagnosis of lentigo maligna melanoma was not made unless the epidermis was atrophic and dermal solar elastosis was present. The new group of lentigo maligna melanomas is dominated by cases on the head among patients over 50 years of age (especially women). This is in better agreement with other studies than our previous findings. The relationship with tumour cell type, pigmentation, mitotic count, atypia, transsectional profile, level of invasion, ulceration, vascular invasion, lymphocyte infiltration and prognosis shown by the new groups of lentigo maligna melanoma and superficial spreading malignant melanoma indicates that the cases by which the diagnosis has been changed are relatively benign. Our previous conclusions are still valid. The lentigo maligna melanoma is still the most benign type and nodular malignant melanoma still the most malignant type of melanoma. The superficial spreading malignant melanoma still represents an intermediate tumour type, although it has deviated in the benign direction.

Adult↗
PubMed1992

Cryosurgery of lentigo maligna.

Lentigo maligna denotes flat, pigmented lesions predominantly in areas of actinic damage that have the propensity to become malignant. More than 10 years may pass before lentigo maligna evolves into an invasive neoplasma. As an invasive process, it is termed lentigo maligna melanoma (LMM), and it has the potential for both lymphatic and hematogenic metastases. Because of the size and location of the lesions, cosmetically unsatisfactory scars may result from conventional surgery. Therefore, alternative means of treatment, including cryosurgery, have been employed. We report on 12 patients suffering from lentigo maligna who had been treated successfully by cryosurgery between 1984 and 1990. The average follow-up period was 51.4 months, and the recurrence rate was 8.3 percent. Knowing that microinvasive components can be demonstrated in 15 percent of lentigo maligna lesions, we retrospectively reassessed our patients by immunohistochemical procedures with S-100 protein. Although intradermal microinvasion could be confirmed in one patient, no recurrence had been observed within 61 months of follow-up. Provided that patients are selected properly and extension of cryonecrosis is monitored, cryosurgery may prove an efficient alternative to conventional surgery in the treatment of lentigo maligna.

Aged↗
PubMed1992

Reactive lentiginous hyperpigmentation after cryosurgery for lentigo maligna.

BACKGROUND: Twenty patients treated for lentigo maligna of the face with cryosurgery developed benign lentiginous hyperpigmentation mimicking a recurrence. OBJECTIVE: When cryosurgery is used in the treatment of lentigo maligna, it is important to know whether repigmentation of the scar represents true recurrence or a benign process. METHODS: Twenty patients were treated with cryosurgery for lentigo maligna of the face. Within a follow-up period of 7 to 80 months, frequent clinical observations were made. RESULTS: Lentiginous hyperpigmentation developed within the treatment area in eight patients. Histologic investigation revealed recurrence of lentigo maligna in three and benign hyperpigmentation in five. CONCLUSION: Genetic factors and UV exposure after cryosurgery may favor the development of benign lentiginous hyperpigmentation. Because recurrence of lentigo maligna must be considered, histologic evaluation of repigmentation is mandatory.

Aged↗
PubMed1975

Lentigo senilis and its evolutions.

Histologic studies have shown the evolution of lentigo senilis and have established the relationship between lentigo senilis, solitary lichen planus-like keratosis, and the reticulated form of seborrheic verruca. Histologic differentiation can be made between lentigo senilis and the early light-brown stage of lentigo maligna.

Aged↗
PubMed1975

Topical chemotherapy of lentigo maligna with 5-fluorouracil.

Three patients with biopsy-proven lentigo maligna were treated with topical 5-fluorouracil. Treatment consisted of twice daily application of 5% 5-fluorouracil cream for 13, 6, and 9 weeks, respectively. Two patients demonstrated presence of invasive melanoma; in one the melanoma was evident before chemotherapy, and in the other the lesion became evident after chemotherapy. In both the lentigo was treated topically and the melanoma excised locally. Posttreatment followup times through April 1, 1974 have been 42, 24, and 22 months, respectively. There has been no evidence of metastases in any patient. Topical chemotherapy with 5-fluorouracil cream appears to offer an encouraging alternative method of therapy for lentigo maligna of the face.

Aged↗
PubMed1992

Large-cell acanthoma is a solar lentigo.

On the basis of a study of 54 specimens each of large-cell acanthoma, solar lentigo, reticulated seborrheic keratosis, and lichen planus-like keratosis, it is concluded that clinically, histopathologically, and biologically, large-cell acanthoma is a variant of solar lentigo, and solar lentigo (including the large-cell variant) is a stage in the evolution of reticulated seborrheic keratosis and of lichen planus-like keratosis.

Adult↗
PubMed1979

Premature cataracts associated with generalized lentigo.

Generalized lentigo (leopard syndrome) is an autosomal dominant trait characterized by lentigo, sensorineural deafness, retarded growth (below 25%), ocular hypertelorism, mandibular prognathism, pectus carinatum or excavatum, dorsal kyphosis, winging of the scapulae, valvular pulmonary artery stenosis, electrocardiographic conduction defects, and genitourinary defects. Ocular evaluations of patients with generalized lentigo have revealed the appearance of multiple small white punctate and comma-shaped opacities in the cortex and nuclci of the lenses of affected patients. On the basis of age of the patients examined, it would seem that the corneal opacities first appear in the third decade. Although the opacities may be extensive, the lens opacities do not appear to impair visual function until approximately twenty years after they first appear.

Adolescent↗
PubMed1987

Microinvasive lentigo maligna melanoma.

Ninety-one skin biopsy specimens previously identified as lentigo maligna were examined for the presence of microinvasion, using the demonstration of S100 protein within atypical cells as the means for locating these superficial foci. In 14 cases, atypical melanocytes were identified, most often in the papillary dermis. The mean depth of invasion in this group was 0.23 mm with a range of 0.10 mm to 0.75 mm. In these cases, atypical cells were difficult if not impossible to identify in routinely processed sections, either because the invasive cell was a spindle cell variant and indistinguishable from a fibrohistiocytic cell, because the invasive cells were occasionally solitary or in small groups, or because there was an inflammatory infiltrate that obscured the tumor cells. Recent studies of lentigo maligna melanoma have revealed no better prognosis when compared to that of other forms of malignant melanoma after normalization for depth and body location. We therefore advocate close examination of lentigo maligna with the use of appropriate immunohistochemical techniques if there are areas of dermal fibrosis or inflammation that might obscure invasion.

Aged↗
PubMed1976

[Malignant lentigo on glans penis. Differentiation using a new method].

A lentigo maligna melanoma on the glans penis and the orificium urethrae is described. From the clinical point of view a superficial spreading melanoma as well as a lentigo maligna could be considered as differential diagnoses. The flat part of this lesion, however, was a lentigo maligna when investigated using a lightmicroscope and especially fluorescence-microscope. In the lightmicroscope only single heavily pigmented and dendritically branched cells could be seen in the basal parts of the epidermis. The definite shape of the other tumor cells was not identifiable. With the fluorescence microscope, however, in nearly all fluorescing and atypical pigment cells, dendritic branching clearly was present.

Cytodiagnosis↗
PubMed1989

Amelanotic lentigo maligna melanoma: a unique case and review of the literature.

It has been estimated that 2 percent of all melanomas are clinically amelanotic, with amelanotic lentigo maligna melanoma being an even rarer presentation. These neoplasms have presented clinically as neurodermatitis, eczema, and erythema. Given the lack of clinical markers and subsequent delay in diagnosis of these lesions, they are potentially more dangerous than pigmented lentigo maligna melanomas. We report a case of an amelanotic lentigo maligna melanoma presenting as an ill-defined edematous area on the left cheek of an elderly woman.

Aged↗