ENTtoday
  • Home
  • COVID-19
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Identifying Lentigo Maligna Often Requires a Multidisciplinary Approach

by Ed Susman • June 1, 2006

  • Tweet
  • Email
Print-Friendly Version

NAPLES, Fla.-Doctors who deal with head and neck surgery often are the ones to first diagnose and potentially treat a variety of facial lesions-and they are more and more often finding themselves dealing with lentigo maligna.

You Might Also Like

  • A Practical Protocol: Identifying Thyroidectomy Patients at Low Risk for Significant Hypocalcemia
  • Management of Dysphagia Requires a Team Approach
  • End-to-End Blood Vessel Coupler Also Safe, Effective in End-to-Side Use
  • Does a Multidisciplinary Approach to Voice and Swallowing Disorders Improve Therapy Outcomes?
Explore This Issue
June 2006

The challenge is identifying the lesion properly-discriminating between classifications of lentigo maligna, melanoma in situ, atypical junctional melanocytic hyperplasia, or benign brown spots-and then deciding how aggressively the lesion has to be treated. For this reason, he said, the decision often requires the input of a dermopathologist.

This is the dilemma we run into with lentigo maligna, cautioned William Shockley, MD, Professor and Chief of the Department of Otolaryngology-Head and Neck Surgery and Chief of Facial Plastic and Reconstructive Surgery at the University of North Carolina-Chapel Hill, in a panel discussion here at the meeting of the Southern Section of the Triological Society. It’s a tough call, he said, especially since the true margin of the lesion extends beyond the visible margin.

A Growing Problem

The incidence of lentigo maligna is rising, Dr. Shockley said. Lentigo maligna is the most common subtype of melanoma in situ. Progression of lentigo maligna leads to its invasive counterpart: lentigo maligna melanoma. Various studies have indicted that the lifetime risk for invasive melanoma arising from lentigo maligna ranges from 5% to 50%.

He said the problem with lentigo maligna is that if it is not treated properly, there is a high probability that it can recur-and it could recur as malignant melanoma. The question, he suggested, is to how wide and how deep the margins should be to make sure the excision of the lesion is complete.

Lentigo maligna was one of the concerns Dr. Shockley and other panel members discussed during the final presentation at the meeting, which offered a primer in how to deal with head and neck lesions and how to correct these conditions without disfiguring the patient.

Characteristics of Lentigo Maligna

Dr. Shockley described lentigo maligna as a slowly growing, asymmetrical macule, varying in color from brown to black with irregular borders, usually found on the face or neck. The distribution of lentigo maligna lesions on the face closely parallels that of actinic keratoses and squamous cell carcinoma.

It occurs to people with a general history of prolonged exposure to the sun, he said, occurring in older adults most frequently. The average age for a patient with lentigo maligna is 63 years. The flat, pigmented lesions are usually seen with they are between 1 and 3 cm in diameter.

Figure. The new wonder drug for actinic keratosis (pictured) is the topical 5% imiquimod cream.

click for large version
Figure. The new wonder drug for actinic keratosis (pictured) is the topical 5% imiquimod cream.
Figure. If not treated properly, lentigo maligna (left) can recur as lentigo maligna melanoma (right).Stedman's (left) Goodheart's Photoguide of Common Skin Disorders, Lippincott Williams & Wilkins (right).

click for large version
Figure. If not treated properly, lentigo maligna (left) can recur as lentigo maligna melanoma (right).Stedman’s (left) Goodheart’s Photoguide of Common Skin Disorders, Lippincott Williams & Wilkins (right).

When confronted with lentigo maligna, most doctors opt for surgical excision, he said. At some centers, Mohs microscopic surgery is the therapy of choice, he said. Radiation is also selectively used, particularly in cases of large lesions, especially among older individuals. Dr. Shockley said other therapies for lentigo maligna include cryosurgery, laser ablation, electrodesiccation and curettage, and topical agents.

Pages: 1 2 3 4 | Single Page

Filed Under: Departments, Facial Plastic/Reconstructive, Head and Neck, Medical Education, Practice Focus Tagged With: cancer, carcinoma, collaboration, facial, laser, lentigo maligna, reconstructive, research, surgeryIssue: June 2006

You Might Also Like:

  • A Practical Protocol: Identifying Thyroidectomy Patients at Low Risk for Significant Hypocalcemia
  • Management of Dysphagia Requires a Team Approach
  • End-to-End Blood Vessel Coupler Also Safe, Effective in End-to-Side Use
  • Does a Multidisciplinary Approach to Voice and Swallowing Disorders Improve Therapy Outcomes?

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Weaning Patients Off of PPIs
    • Vertigo in the Elderly: What Does It Mean?
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Podcasts Becoming More Popular Method of Education for Otolaryngologists
    • How to Embrace Optimism in the Midst of the COVID-19 Pandemic
    • Tips on How to Approach Conversations with Patients about the COVID-19 Vaccine
    • Steps You Should Take to Protect Your Voice and Hearing During Telemedicine Sessions
    • Routine Postoperative Adjunct Treatments Unnecessary for Idiopathic Cerebrospinal Fluid Leaks

Polls

Have you spoken with your patients about receiving the COVID-19 vaccine?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2021 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.