Clinical and Dermoscopic Features of Lentigo Maligna

Danica Tiodorović^1,2, Danijela Popović¹, Sladjana Cekić¹, Milica Radić³, Aleksandar Popović⁴, Nataša Vidović⁵, Andrija Jović¹

 

¹Clinic of Dermatovenerology, University Clinical Center Niš, Niš, Serbia
²University of Niš, Faculty of Medicine, Niš, Serbia
³University Clinical Center Niš, Oncology Clinic, Department of Radiotherapy, Niš, Serbia
⁴University Clinical Center Niš, Oncology Clinic, Niš, Serbia
⁵Center for Pathology and Pathological Anatomy, University Clinical Center Niš, Niš, Serbia

 

 SUMMARY

   

Introduction/Aim. Lentigo maligna (LM) represents an in situ melanoma that develops on chronically photo-damaged skin. Clinical diagnosis of LM is often difficult, even for experienced dermatologists. The aim of the study was to analyze the clinical and dermoscopic features of patients with pathohistologically verified lentigo maligna (LM) and to determine a possible influence of anatomical topography, age and gender in the dermoscopic features of LM.

Patients and methods. This retrospective study included 32 patients with 32 LM changes in total, diagnosed between 2017 and 2020. Clinical data recorded from each patient included the following: demographic features (age, gender), anatomic localization (facial or extrafacial) and clinical size (< 10 mm or > 10 mm). Facial area was subdivided into eight topographical sites, while extrafacial localization involved any location outside the face region. All dermoscopic images were analyzed for the presence of dermoscopic features previously described as LM.

Results. In the total of 32 patients, there were 19 males and 13 females. The patients’ age ranged from 34 to 80 years (median age 60.1 ± 10.4 years).  Significant female predominance was observed for localization on the cheeks (p = 0.018). Localization on the nose was significantly associated with patients older than 65 (p = 0.039). The most frequent dermoscopic features were asymmetric pigmented follicular openings in 23 (71.9%) cases, gray color in 22 (68.8%) and pigmented rhomboidal structures in 15 (46.9%) cases. In relation to age and specific dermoscopic features, gray color (p = 0.035) and white scar-like areas (p = 0.012) were significantly higher in patients older than 65, while pigmented rhomboidal structures (p = 0.041) were significantly associated with younger patients.

Conclusion. The observed differences in the frequency of clinical and dermoscopic features of LM have significant importance in everyday clinical practice and can assist clinicians in the early diagnosis of this malignant tumor.

 

Keywords: lentigo maligna, dermoscopy, differential

 

 Corresponding author:
  Danica Tiodorović
  e-mail: danica.dr@gmail.com