Which conditions are included in the differential diagnoses of lentigo maligna melanoma?

Updated: Dec 19, 2019
  • Author: Winston W Tan, MD, FACP; Chief Editor: William D James, MD  more...
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Distinguishing lentigo maligna from its invasive counterpart on a clinical basis continues to present diagnostic dilemmas, especially in patients who had previous therapeutic interventions such as cryotherapy. It is important to have a low threshold for biopsy of pigmented facial lesions. In a series of 85 excised lesions with a clinical diagnosis of lentigo maligna, more than 50% had invasive lentigo maligna melanoma.

The following conditions should also be considered when evaluating a patient for suspected lentigo maligna and lentigo maligna melanoma:

  • Common acquired nevi
  • Dysplastic nevi
  • Pigmented actinic keratosis
  • Seborrheic keratosis
  • Solar lentigo (see the image below)
Woman with solar lentigo. Common in sun-exposed sk Woman with solar lentigo. Common in sun-exposed skin, solar lentigines are benign lesions that must be distinguished from lentigo maligna melanoma.

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