Lentigo Maligna, Macules of the Face, and Lesions on Sun-Damaged Skin : Confocal Makes the Difference - 12/10/16

Doi : 10.1016/j.det.2016.05.005

Phoebe Star, MBBS, BSc, BA ^a, Pascale Guitera, MD, PhD, FACD ^b,^⁎
^a Department of Dermatology, Melanoma Institute Australia, 40 Rocklands Road, North Sydney, New South Wales 2060, Australia
^b Dermatology, Sydney Melanoma Diagnostic Centre (SMDC), Royal Prince Alfred Hospital, Melanoma Institute Australia, Central Clinical School, Sydney University, Missenden Road, Camperdown, New South Wales 2050, Australia

^∗Corresponding author.

Résumé

Distinguishing lentigo maligna (LM) and lentigo maligna melanoma (LMM) from background pigmented non-melanoma lesions is challenging. The field of solar damage can obscure clinical assessment, and diagnostic ambiguities are created due to the overlap of the clinical features of LM with other benign lesions. Moreover, margin assessment on histology is limited by the resemblance between melanocytic hyperplasia of actinically damaged skin and scattered atypical melanocytes of LM/LMM. Dermoscopy has made a significant contribution but is often not sufficient for diagnosis and margin assessment. Confocal microscopy has become an important complementary tool in enhancing the management of these complex lesions.

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Keywords : Lentigo maligna, Melanoma, Benign facial macules, Solar damage, Confocal microscopy