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Lentigo maligna: Clinical manifestations, diagnosis, and management

Arthur J Sober, MD
Suzanne Olbricht, MD
Section Editor
Hensin Tsao, MD, PhD
Deputy Editor
Rosamaria Corona, MD, DSc


Lentigo maligna (LM) is a type of melanoma in situ that typically occurs in sun-damaged skin of the face and neck of older individuals [1]. LM evolves slowly over many years and may progress to invasive lentigo maligna melanoma. "Hutchinson melanotic freckle" and "melanosis circumscripta precancerosa of Dubreuilh" are synonyms of LM [2,3].

This topic will discuss the clinical features, diagnosis, and treatment of lentigo maligna. Lentigo maligna melanoma is discussed separately. (See "Clinical features and diagnosis of cutaneous melanoma", section on 'Lentigo maligna melanoma' and "Pathologic characteristics of melanoma", section on 'Lentigo maligna melanoma'.)


Lentigo maligna (LM) usually occurs in older individuals with a peak incidence between 65 and 80 years [4,5]. The incidence of LM appears to be increasing in younger age groups. One study reported a 52 percent increase in the incidence rate of LM among men and women aged 45 to 64 years between 1990 and 2000 in the United States [6]. Another population study reported an increase in incidence from 2.2 per 100,000 per year between 1970 and 1989 to 13.7 per 100,000 per year between 2004 and 2007 in the United States [7]. The risk of LM and lentigo maligna melanoma is higher in fair skinned individuals with markers of actinic skin damage (solar lentigines and actinic keratoses) and a history of nonmelanoma skin cancer [8,9].

LM is a slowly evolving lesion and is often diagnosed years or decades after its occurrence. In some lesions, partial central regression may occur while the peripheral margin continues to extend [10,11]. The time to progression of LM to invasive lentigo maligna melanoma ranges from less than 10 to more than 50 years [10,12].

The lifetime risk of progression of lentigo maligna to a lentigo maligna melanoma was estimated to be about 5 percent [13]. However, these data are old and in some series, up to 20 percent of patients undergoing excision for LM were found to have invasive disease [14-17].


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Literature review current through: Sep 2016. | This topic last updated: Jun 9, 2015.
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