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Lentigo
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Lentigo maligna is considered to be a preinvasive lesion induced by the long-term cumulative ultraviolet injury. Conceptually, the term melanoma is used when atypical melanocytes invade the rich vascular and lymphatic networks of the dermis; thereby establishing metastatic potential Melanome is second only to adult leukemia is years of potential life lost.

The disease is responsible for death in a disproportionately high number of young and middle-aged adults. Females are more commonly affected than males with lentigomaligna. Patients with lentigomaligna tend to be older than those with superficial spreading malignant melanoma or nodular melanoma.

Generally, patients with lentigo maligna tend to the older than those with superficial spreading malignant melanoma or nodular melanoma. Generally, patients with lentigo maligna are older than 40 years, with a mean age of 65 years. The peak incidence occurs in the seventh to eight decades of life.

Causes of Lentigo

The risk of lentigo maligna increases as the number of years of residence in sunnier climates increases and the risk increases with increased hours of exposure to sunlight, increased amount of actinic damage and history of nonmelanoma skin cancer.

Lentigomaligna is found to be associated with Basal Cell Carcinoma, Light Skin Colour, History of severe sunburn, Porphyria cutanea tarda, Werner syndrome, Xeroderma, pigmentosa Tyrosine-Positive oculocutaneous albinism. Increased number of melanocytic nevi, including large or giant congenital nevi, also leads to the development of Lentigo maligna.

Symptoms of Lentigo

Lentigo maligna most commonly affects the sun-exposed skin of the head and neck. But it can also affect the nose and cheek. In certain people, the lesions occur more commonly on right side, that is driver side, of the head and neck in men and on the left side, that is passenger’s side in women.

Doctor should suspect the possibility of melanoma if a patient complains of a new-pigmented lesion or changes in an existing mole. The lentigo maligna may also include the arm, leg and trunk in certain rare cases. The conjunctivae and oral mucosa may become involved when a coetaneous lentigo maligna spreads onto mucosal surfaces.

Signs suggestive of a more locally advanced lesion include elevation, burning, itching, pain or bleeding. Lentigo maligna, the precursor lesion has been likened to a stain on the skin.

The lesion typically is tan-brown with different shades throughout. Irregular mottling or flecking may appear as the lesion enlarges, with areas of dark brown or black in some parts and lightening in others. This precursor lesion can be present for long periods before invasion occurs.

The percentage of lentigo maligna that progress to lentigo maligna melanoma remains unknown, but estimates of the lifetime risk of lentigo maligna are known to be 4.7% at age of 45 years.

Treatment of Lentigo

The lentigo maligna is managed with definitive surgical therapy. The actual margins of a lesion usually extend beyond the clinically apparent margin and therefore total removal may be difficult.

The overall prognosis is good for patients with localized melanoma and not nodal or distant metastases: Follow-up consists of examination of the skin, the primary site and the regional nodal basin. If the patient is disease free at 2 years, then yearly follow-up visits should be conducted.



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