Lentigo Maligna

Melanoma, a type of skin cancer is categorized into four types, three are 'in situ' and the fourth type is invasive. In situ is a very early stage of melanoma and does not invade enough to be considered invasive. Lentigo Maligna is 'in situ'. The cancer cells are in the top layer of the skin (epidermis) and are contained in the area in which the cells started to develop. If left untreated, 'in situ' lentigo maligna can become invasive.

• Lentigo maligna is more common in males.
  
• Working outdoors (exposure to UV rays) increases risk.
  
• Early childhood exposure to sunburn blisters increases chance of developing at later stage of life.
  
• Family history increases chance of developing lentigo maligna.
  
• Begins as a patch.
  
• Occurs around hair follicles on the sun-damaged skin of the head and neck or even face.
  
• Grows very slowly over many years.
  
• Diagnosed usually during middle age and the elderly.

Lentigo Maligna - ABCD rule

Initially, it appears as a mole in the sun exposed areas. Over time, it grows into an odd-looking, multi-colored structure that doesn't go away. The ABCD rule is useful to recognize lentigo maligna. Considering these as lentigo maligna symptoms, without any delay, it is best to seek medical attention.

A: Stands for asymmetry. The mole can be anywhere on the skin which is not symmetric in shape.

B: Stands for border. The border of the mole is ragged, notched, and irregular.

C: Stands for color. The mole is multi-colored, a mixture of brown, black, red, blue or white in varying shades and patterns.

D: Stands for diameter. The size of the mole is more than 6mm.

Lentigo maligna diagnosis

Post a visual examination of the affected areas, a skin biopsy is recommended by the doctor. A biopsy is required for diagnosis. The biopsy involves removing the growth and a small part of the surrounding skin to analyze it under a microscope. Confirming lentigo maligna diagnosis, the doctor determines the best course of treatment.

Lentigo maligna treatment

Early detection and medical attention restrains the lesions or mole from spreading across the skin's surface. If left untreated, it can spread deeper into the skin and can eventually pass to other parts of the body.

Slow Mohs is a preferred surgical technique for completely removing the melanoma. Along with it, about 5mm margin of normal tissue is also excised. Radiation or cryosurgery is resorted to when the lesion is difficult to access and excise. Under local anaesthesia, surgery is performed. Healthy tissues around the area are also removed as a precautionary step leaving no cancerous cells. If the mole or lesion is in an area where spare skin is not available, like the face or lower leg, skin graft to remove the lesions may be required. A plastic surgeon would remove skin and replace it from another area. A follow-up visit may or may not be required.

Lentigo maligna self care tips

Lentigo maligna is not hereditary but it is more likely to develop when a close relative has suffered a melanoma. Self care tips can prevent getting another lentigo maligna.

• Monthly self examination of the whole body applying ABCD lentigo maligna rule.
  
• Protect your skin from too much exposure to the sun. Use sun-care tips like sun protection cream, wearing a hat, cotton clothes, avoiding sun bathing, sunburn and tanning etc.
  
• Avoid sun beds and tanning lamps.
  
• Avoiding direct sunlight exposure can be substituted to an extent with Vitamin D supplements.
  
• Inform family members particularly the youngsters keeping in mind the genetic influence.