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Lentigo maligna with spread onto oral mucosa
George Kroumpouzos1, E William Frank, John G Albertini
1Department of Dermatology, Veterans Affairs Medical Center, Brockton, MA, USA. lcohen@cohenderm.com
Archives of Dermatology
|September 13, 2002
Summary
Lentigo maligna (LM), a melanoma in situ, can spread from the perioral area to the oral mucosa. This rare presentation requires careful examination of atypical pigmented lesions to prevent recurrence and progression.
Area of Science:
- Dermatology
- Oncology
- Oral Medicine
Background:
- Lentigo maligna (LM) is a melanoma in situ typically affecting sun-exposed skin in fair-skinned individuals.
- While conjunctival spread is documented, oral mucosal involvement of LM has not been previously reported.
- This study investigates the rare occurrence of LM extending to the oral mucosa.
Observation:
- Four cases of LM with contiguous spread from perioral skin to oral mucosa in white women are presented.
- Lesion locations included the lip vermilion, perioral skin, and cheek.
- Three cases demonstrated invasive progression, and all experienced recurrences post-surgery.
Findings:
- Perioral lentigo maligna can extend onto the oral mucosa.
- This presentation is associated with significant morbidity, including high recurrence rates and potential progression to invasive melanoma.
- Surgical excision, particularly Mohs surgery, offered better remission rates compared to laser treatment.
Implications:
- Clinicians should examine oral mucosa in patients with atypical pigmented perioral lesions.
- Early detection and management are crucial to minimize morbidity associated with oral mucosal LM.
- This finding expands the known clinical spectrum of lentigo maligna.