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Lentiginous melanoma (lentigo maligna and lentigo maligna melanoma) in Australia: clinicopathological characteristics, management and recurrence rates after 10‐year follow‐up at a tertiary centre
Author(s) -
Collgros H.,
RodriguezLomba E.,
Regio Pereira A.,
Lo S.N.,
Scolyer R.A.,
Guitera P.
Publication year - 2021
Publication title -
journal of the european academy of dermatology and venereology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.655
H-Index - 107
eISSN - 1468-3083
pISSN - 0926-9959
DOI - 10.1111/jdv.17135
Subject(s) - medicine , lentigo maligna , lentigo maligna melanoma , melanoma , acral lentiginous melanoma , dermatology , nodular melanoma , retrospective cohort study , lentigo , surgery , cancer research
Background Lentiginous melanoma or lentigo maligna is a slow‐growing type of melanoma frequently arising in sun‐damaged skin and often first diagnosed in the elderly. Few studies report long‐term follow‐up. Objectives To define characteristics of lentiginous melanoma in situ (LM) and invasive lentiginous melanoma (LMM) in Australian patients managed at a tertiary centre and describe local recurrence or treatment failure rates after long‐term follow‐up. Methods Retrospective single‐centre study of LM/LMM patients evaluated between January 2005 and March 2007. Medical and photographic records were reviewed. Results One hundred two patients were included, with a total of 117 lesions (70 LM and 47 LMM). Seventy‐nine were new primary LM/LMM, and 38 were recurrences. Primary cases were mostly pigmented (71%), while 77% of recurrent cases were partially pigmented/light brown or amelanotic. The margins were clinically ill‐defined in the majority of cases (64% of primary cases and 94% of recurrent cases). Dermoscopy of the primary LM/LMM showed either classic ‘common’ melanoma features (33%) or classic LM/LMM features (41%), while 95% of recurrent cases had no features for melanoma or LM/LMM. Primary cases that were initially excised (113, 97%) had mean histopathological clear margins of 4.9 mm (range 0.1–22 mm). The median follow‐up time was 7.5 years (95% CI 5.2–10.0) with more than 10‐year follow‐up in 32% and 5–10 years in 24% of patients. There were 44 (38%) recurrences over the entire follow‐up period. Half of the patients who recurred did so within the first 3.8 years after the first treatment. Conclusion LM/LMM often recur late and are clinically subtle; therefore, careful monitoring and long‐term follow‐up are required.