Lentigo maligna part II: Management

Abstract

Lentigo maligna arises on chronically-sun damaged skin and can have extensive subclinical spread, often in functionally and cosmetically challenging areas. This two-part continuing medical education series reviews lentigo maligna. Part I reviews epidemiology, risk factors, clinical presentation, diagnostic tools, biopsy technique, and histopathology of lentigo maligna. Part II reviews both surgical and nonsurgical treatment options. Surgical approaches – including conventional excision, Mohs micrographic surgery, and staged excision – remain first-line therapy to achieve cure. Some patients may be poor surgical candidates or elect for alternative treatments. Nonsurgical modalities, such as topical and radiation therapy, are also reviewed. Finally, surveillance recommendations are discussed.