Lentigo Maligna
Also
known as: Hutchinson’s Freckle
What
is it?
Lentigo
maligna, also known as Hutchinson’s freckle, is a
type of malignant melanoma (skin cancer) that
appears as flat patches of skin on sun-exposed
areas. It is one of the four major types of
melanoma and has the most favorable prognosis
because there is less risk of it spreading to
other areas of the body.
Who
gets it?
Lentigo
maligna is mostly seen in patients 50 to 80 years
old and accounts for ten to 15 percent of skin
cancer cases.
What
causes it?
A
sunburn early in life and the presence of large or
numerous nevi (a type of birth mark) can cause
lentigo maligna. Patients with a large congenital
nevi (greater than 20 centimeters in diameter)
have a five to 20 percent lifetime chance of
developing melanoma. Sunlight exposure is a major
cause of melanoma; migration studies show that the
risk of melanoma increases in populations that
move to areas with increased sunlight. Depletion
of the ozone layer, resulting in an increase in
ultraviolet light reaching the earth, may also be
an important contributing factor.
Other
possible risk factors of lentigo maligna include
both pregnancy and the prolonged use of oral
contraceptives, although there are few cases of
lentigo maligna from these causes.
What
are the symptoms?
Symptoms of lentigo maligna are lesions on the
skin that appear tan to brown and occur on the
head, neck and back of the hands. They are
typically two to six centimeters in length and are
irregularly shaped with darker spots.
How is
it diagnosed?
A
doctor may diagnose lentigo maligna by using The
American Cancer Society’s ABCD mnemonic, which
stands for asymmetry, border irregularity, color
variation and diameter greater than five
millimeters. The doctor may obtain a family
history to check for the occurrence of melanoma
and other cancers among the patient’s relatives.
The
doctor may perform an excisional biopsy to confirm
diagnosis of a suspicious melanoma. During the
biopsy, an incision is made that includes both the
suspicious area (the most raised or most deeply
pigmented portion) and a small area of normal
skin.
The
doctor may also evaluate common sites where the
cancer may spread such as the skin, lymph nodes,
bone, lungs, liver, spleen and central nervous
system.
What
is the treatment?
The
doctor may evaluate sites of lentigo maligna, the
speed of progression and the general health and
fitness of the patient when choosing a treatment.
Surgery, radiation therapy and chemotherapy may
all be used in the treatment of lentigo maligna.
Surgery rarely cures the disease, and may be used
as a last resort after other treatments have
failed. After the initial diagnosis, the doctor
may recommend the patient be examined every three
months for two years, and twice a year thereafter.
Self-care tips
Survival rates of patients diagnosed with lentigo
maligna can be improved through early detection,
promoting patient awareness and self-examination,
and encouraging regular physical examinations of
patients who are at increased risk of the disease.
Sunscreen use and avoiding intense, intermittent
sun exposure may also be recommended.
This information has been designed as a comprehensive and quick reference
guide written by our health care reviewers. The health information written
by our authors is intended to be a supplement to the care provided by your
physician. It is not intended nor implied to be a substitute for
professional medical advice.
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