Lentigo maligna: review of salient characteristics and management

Am J Clin Dermatol. 2013 Dec;14(6):473-80. doi: 10.1007/s40257-013-0044-6.


Lentigo maligna is a melanocytic neoplasm, often regarded as 'melanoma in situ,' which may progress to lentigo maligna melanoma. Lentigo maligna clinically presents as a pigmented, asymmetric macule that originates on the head and neck and spreads slowly. The preferred method for diagnosing lentigo maligna is excisional biopsy. Histology shows proliferation of atypical melanocytes at the epidermal-dermal junction in small nests or single cells. The differential diagnosis includes solar lentigo, seborrheic keratosis, lichen planus-like keratosis, pigmented actinic keratosis, and melanocytic nevus. Stains used in diagnosis include hematoxylin and eosin, HMB-45, MART-1/Melan-A, Mel-5, and S-100. Surgical excision is the preferred treatment for lentigo maligna. Second-line techniques include medical (topical imiquimod) and destructive therapy.

Publication types

  • Review

MeSH terms

  • Biopsy
  • Diagnosis, Differential
  • Disease Progression
  • Head and Neck Neoplasms / diagnosis
  • Head and Neck Neoplasms / pathology*
  • Head and Neck Neoplasms / therapy
  • Humans
  • Hutchinson's Melanotic Freckle / diagnosis
  • Hutchinson's Melanotic Freckle / pathology*
  • Hutchinson's Melanotic Freckle / therapy
  • Melanoma / etiology
  • Melanoma / pathology
  • Melanoma / therapy
  • Skin Neoplasms / diagnosis
  • Skin Neoplasms / pathology*
  • Skin Neoplasms / therapy