Clinical diagnosis

Lentigo Maligna (LM) represents in situ melanoma that develops in chronically sun-damaged skin-often on the face of elderly Caucasian patients. Most LMs present as asymmetric brown-black macules or patches with variegated color and irregular borders. Diagnosis of LM is often delayed due to its slow growth and the fact that many benign but similar appearing lesions also develop in these patients. Various techniques can be used to biopsy a concerning lesion. When LM is diagnosed on a small incisional biopsy and significant clinically evident lesion remains, the practitioner must be mindful of possible sampling error since 4-16 % of LM lesions have been found to contain an invasive component.