Careful monitoring and long‐term follow‐up are required for lentiginous melanoma
February 16, 2021
Abstract
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:
102 patients were included, with a total of 117 lesions (70 LM and 47 LMM). 79 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 years 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.
Source:
Collgros, H., Rodriguez‐Lomba, E., Regio Pereira, A., Lo, S., Scolyer, R. and Guitera, P. (2021), Lentiginous melanoma (lentigo maligna and lentigo maligna melanoma) in Australia: clinicopathological characteristics, management and recurrence rates after 10 years follow‐up at a tertiary centre. Journal of the European Academy of Dermatology and Venereology. Accepted Author Manuscript. https://doi.org/10.1111/jdv.17135