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Lentigo Maligna Melanoma

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Cutaneous Melanoma

Abstract

Lentigo maligna melanoma is an increasingly common melanoma subtype worldwide, occurring mainly on the head and neck of older, light-skinned individuals. This subtype poses specific challenges in diagnosis and management, including histologic differentiation from surrounding sun-damaged skin with atypical melanocytes, optimizing treatment in anatomically constrained sites where this melanoma subtype tends to occur, and reducing local recurrence rates related to subclinical extensions, all while taking into account quality of life issues and suitability of surgical, topical, and/or radiation therapy in an elderly population. Noninvasive tools such as dermoscopy and reflectance confocal microscopy can facilitate early diagnosis. Treatment options include surgical and nonsurgical modalities which are complicated by frequent subclinical extension of the tumor and more complex anatomic location. Surgical options include conventional wide excision and techniques that provide exhaustive peripheral margin control, including staged excision with permanent sections and Mohs micrographic surgery, both of which may reduce rates of local recurrence. Nonsurgical therapies include off-label topical imiquimod and radiation therapy, which are generally second-line but may be preferable in certain instances based on patient comorbidities and/or limited life expectancy, quality of life issues, and/or preference for nonsurgical treatment. Recurrence may occur years after initial treatment, necessitating the need for long-term follow-up.

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Authors and Affiliations

  1. Melanoma and Skin Cancer Unit, Department of Dermatology, Facultad de Medicina, Pontificia Universidad Catolica de Chile, Santiago, Chile

    Cristian Navarrete-Dechent

  2. Dermatology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Cristian Navarrete-Dechent, Anthony M. Rossi, Erica H. Lee & Kishwer S. Nehal

  3. Department of Dermatology, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA

    Kelly C. Nelson

  4. Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Christopher A. Barker

  5. Department of Dermatology, Pigmented Lesion and Melanoma Program, Stanford University Medical Center and Cancer Institute, Stanford, CA, USA

    Susan M. Swetter

  6. Dermatology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA

    Susan M. Swetter

Authors
  1. Cristian Navarrete-Dechent
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  2. Kelly C. Nelson
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  3. Anthony M. Rossi
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  4. Erica H. Lee
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  5. Christopher A. Barker
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  6. Kishwer S. Nehal
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  7. Susan M. Swetter
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Corresponding author

Correspondence to Susan M. Swetter .

Editor information

Editors and Affiliations

  1. Division of Surgical Oncology, University of Texas Southwestern, Dallas, TX, USA

    Charles Balch

  2. Georgetown Medical Center, Washington, DC, USA

    Michael Atkins

  3. Department of Dermatology, University Hospital, Tübingen, Tübingen, Germany

    Claus Garbe

  4. Division of Surgery, UT MD Anderson Cancer Center, Houston, TX, USA

    Jeffrey Gershenwald

  5. Department of Dermatology, Memorial Sloan Kettering, New York, NY, USA

    Allan C. Halpern

  6. Melanoma and Skin Cancer Program, University of Pittsburgh, Pittsburgh, PA, USA

    John M. Kirkwood

  7. Divsions of Cancer Medicine and Research, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia

    Grant A. McArthur

  8. Melanoma Institute of Australia, Wollstonecraft, Australia

    John F. Thompson

  9. Department of Dermatology, Harvard Medical Center, Boston, MA, USA

    Arthur J. Sober

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Navarrete-Dechent, C. et al. (2019). Lentigo Maligna Melanoma. In: Balch, C., et al. Cutaneous Melanoma. Springer, Cham. https://doi.org/10.1007/978-3-319-46029-1_68-1

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  • DOI: https://doi.org/10.1007/978-3-319-46029-1_68-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-46029-1

  • Online ISBN: 978-3-319-46029-1

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