Lentigo maligna melanoma is a form of skin cancer. It is a lesion, or an area of diseased tissue that results in a bumpy, abnormal growth on the skin. Accounting for 15% of all melanomas, lentigo maligna melanoma is often confused with melanoma-in-situ, which identifies a melanoma with cells that are confined to the epidermis layer of the skin.
Lentigo maligna melanoma’s pigment is often dark brown and palpable, and is a few millimeters in diameter. It is the least common type of melanoma and is the slowest growing.
Although that is a plus, lentigo maligna melanoma has the capability of growing and merging with other tumors such as melanocytic nevus. It can easily be treated and does not pose a biological threat to the patient.
Risk Factors
A number of environmental and hereditary factors may play a role in the development of lentigo malgna melanoma:
Number: Often having 100 or more moles
Family History: 10-15% of patients that develop lentigo maligna melanoma have a family member with the disease.
Immune System: Organ transplants and medication that weakens an individual’s immune system may result in the development of lentigo maligna melanoma.
Sun Exposure: Over exposure to sun rays, especially in adolescence, may lead tot he development of lentigo maligna melanoma.
Dysplastic Nevus Syndrome: This skin disorder may increase one’s chances of developing lentigo maligna melanoma.
Xeroderma Pigmentosum: This rare, heredity skin disease caused by a defect in the enzyme that normally repairs ultra-violet damaged DNA may lead to lentigo maligna melanoma development.
Age: This disease typically develops in the elderly.
Signs and Symptoms
The most common technique to remembering the signs and symptoms of lentigo maligna melanoma is the acronym ABCDE:
Asymmetrical skin lesion
Border of area is irregular
Color varies from brown, to tan or pink
Cracking, bleeding, and itching may occur
Diameter of mole is greater than 6mm causing pain and sensitivity
Evolution of mole is a sign of malignancy
Prognosis
The prognosis of lentigo maligna melanoma is fair unless metastasis (spreading) has occurred. A patient’s prognosis depends significantly on the time diagnosis, overall health of the patient, and thickness of the lesion.
Prevention
If lentigo maligna melanoma runs in a patient’s family line, it is advised to have annual skin exams. Self examination is also effective. Taking progressive photographs will better help a skin care physician or doctor observe the mole’s evolution. For every individual, it is very important to wear quality sun screen to protect your skin. Sunscreen with high an SPF of 30 or more is recommended.
Diagnosis and Staging
Diagnosing a lentigo maligna melanoma with the naked eye is impossible. As a result, an excisional biopsy is typically performed to diagnose lentigo maligna melanoma. This procedure involves the removal of the entire or part of the lesion. Afterward, the excised tissue is examined under a microscope in a laboratory.
Lentigo maligna melanoma is staged to determine the extent of metastasis (spread) and overall behavior of the tumor:
Stage I and II: The lesion and its cells are localized to its originating area.
Stage III: The lesion has begun to spread beyond the epidermis.
Stage IV: The tumor has metastasized significantly.
Treatment
Once a patient is diagnosed, the next step is removing the abnormal mole. This usually leaves a scar. Surgery that involves a wide, local incision is the most common treatment option, but it results in a high risk of lesion recurrence. A treatment modality known as cryotherapy limits the progression of melanoma cells.
Cryotherapy involves the use of extreme cold to kill the cells of the lesion. Radiation is occasionally administered to kill melanoma cells, but studies yield mixed results regarding the effectiveness of this treatment option.
