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Background  A higher incidence of lentigo maligna ( LM ) recurrences on the nose was previously observed in our cohort after non‐surgical treatment.    Objectives  To determine histological parameters that might be related to the previously observed higher incidence of  LM  recurrences on the nose after non‐surgical treatment.    Methods  We randomly selected 22 surgical specimens of  LM  on the nose and 22 on the cheek. Histopathological analysis was performed on haematoxylin and eosin stained and microphthalmia transcription factor immunohistochemically stained slides. The number of pilosebaceous units ( PSU ) per mm, maximum depth of atypical melanocytes along the skin appendages and maximum depth of the  PSU  itself were determined.    Results  The nose had a significantly higher density of  PSU  than the cheek. The atypical melanocytes extended deeper along the  PSU  on the nose with a mean ( SD ) depth of 1.29 mm (0.48) vs. a mean depth of 0.72 mm (0.30) on the cheek ( P  < 0.001). The maximum depth of the  PSU  on the nose was greater than on the cheek, mean ( SD ) depth of 2.28 mm (0.41) vs. 1.65 mm (0.82) ( P  = 0.003).    Conclusions  The higher recurrence risk of  LM  on the nose after non‐surgical treatment that we previously observed in our cohort is most likely based on a higher density of atypical melanocytes and also their deeper extension into the follicles. These results shed more light on our previous findings and learn that anatomical location is relevant for the risk of recurrence of  LM  after non‐surgical treatment.

Lentigo maligna – anatomic location as a potential risk factor for recurrences after non‐surgical treatment