Lentigo maligna and lentigo maligna melanoma in patients younger than 50 years: a multicentre international clinical–dermoscopic study

Author:

Longo Caterina12ORCID,Sticchi Alberto12,Curti Alex12,Kaleci Shaniko1,Moscarella Elvira3,Argenziano Giuseppe3,Thomas Luc4,Guitera Pascale567,Huang Chen5ORCID,Tiodorovic Danica8,Apalla Zoe9,Peris Ketty1011,del Regno Laura11,Guida Stefania1213,Lallas Aimilios14,Kittler Harald15,Pellacani Giovanni16,Navarrete-Dechent Cristian1718ORCID

Affiliation:

1. Department of Dermatology, University of Modena and Reggio Emilia , Modena , Italy

2. Azienda Unità Sanitaria Locale – IRCCS di Reggio Emilia, Skin Cancer Center , Reggio Emilia , Italy

3. Dermatology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania Luigi Vanvitelli , Naples , Italy

4. Department of Dermatology, Claude Bernard University Lyon 1, and Cancer Research Center Lyon , Lyon , France

5. Sydney Melanoma Diagnostic Centre, Royal Prince Alfred Hospital , Camperdown, NSW , Australia

6. Faculty of Medicine and Health, The University of Sydney , Camperdown, NSW , Australia

7. Melanoma Institute Australia , Sydney, NSW , Australia

8. Clinic of Dermatovenereology, Clinical Centre Nis, Medical Faculty, University of Nis , Serbia

9. Second Department of Dermatology

10. Dermatologia, Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore , Rome , Italy

11. UOC di Dermatologia, Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli – IRCCS , Rome , Italy

12. School of Medicine, Vita-Salute San Raffaele University , Milan , Italy

13. Dermatology Clinic, IRCCS San Raffaele Hospital , Milan , Italy

14. First Department of Dermatology, School of Medicine, Faculty of Health Sciences, Aristotle University , Thessaloniki , Greece

15. Department of Dermatology, Medical University of Vienna , Austria

16. Department of Dermatology and Venereology at the University of La Sapienza , Rome , Italy

17. Department of Dermatology

18. Melanoma and Skin Cancer Unit, Escuela de Medicina, Pontificia Universidad Catolica de Chile , Santiago , Chile

Abstract

Abstract Background Lentigo maligna/lentigo maligna melanoma (LM/LMM) is usually diagnosed in older patients, when lesions are larger. However, it is important to detect it at an earlier stage to minimize the area for surgical procedure. Objectives To determine and define clinical, dermoscopic and reflectance confocal microscopy (RCM) features of LM/LMM in patients < 50 years old. Methods This was a multicentre study involving tertiary referral centres for skin cancer management. The study included cases of consecutively excised LM/LMM arising in patients < 50 years of age with a histopathological diagnosis of LM/LMM and a complete set of clinical and dermoscopic images; RCM images were considered when present. Results In total, 85 LM/LMM of the face from 85 patients < 50 years were included in the study. A regression model showed a direct association with the size of the lesion (R2 = 0.08; P = 0.01) and with the number of dermoscopic features at diagnosis (R2 = 0.12; P < 0.01). In a multivariable analysis, an increasing number of dermoscopic features correlated with increased patient age (P < 0.01), while the presence of grey colour was a predictor of younger age at diagnosis (P = 0.03). RCM revealed the presence of melanoma diagnostic features in all cases (pagetoid cells and atypical nesting). Conclusions LM is not a disease limited to older people as previously thought. LM presenting in young adults tends to be smaller and with fewer dermoscopic features, making its diagnosis challenging. Careful evaluation of facial pigmented lesions prior to cosmetic procedures is imperative to avoid incorrectly treating early LM as a benign lesion.

Publisher

Oxford University Press (OUP)

Subject

Dermatology

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