Lentigo maligna: diagnosis and treatment

Lentigo maligna is an overgrowth of atypical melanocytes at the dermal-epidermal junction also known as melanoma in situ. Left untreated, these lesions can continue to grow, resulting in dermal invasion and progression to lentigo maligna melanoma. Many operative and nonoperative treatments have been developed with the goals of preserving function and cosmesis while at the same time addressing the diffuse nature of these lesions. Previous recommendations have led plastic surgeons to commonly perform wide local excision with 5 mm margins. More recent literature has suggested that in many cases this treatment can result in high recurrence rates. This has led to margin control procedures becoming the treatment of choice for these lesions.