Dermoscopy findings of a one mm lentigo maligna

Area of Science:

• Dermatology
• Oncology
• Pathology

Background:

• Lentigo maligna (LM) is a common form of melanoma in situ, typically affecting sun-damaged skin on the face and neck.
• Early diagnosis of LM is crucial for effective treatment and preventing progression to invasive melanoma.
• The Schiffner progression model describes the evolution of dermatoscopic features in LM.

Observation:

• A 66-year-old man presented with a small, grayish macule on his left cheek.
• Dermatoscopy revealed annular-granular structures surrounding a single hair follicle.
• Histopathology confirmed atypical melanocytes consistent with lentigo maligna.

Findings:

• The observed annular-granular structures surrounding a hair follicle may represent the earliest dermatoscopic sign of lentigo maligna.
• This finding supports the Schiffner progression model, indicating a potential early stage in LM development.
• The case highlights the diagnostic utility of specific dermatoscopic patterns in identifying early-stage facial LMs.

Implications:

• Early recognition of these dermatoscopic features can lead to earlier diagnosis and treatment of lentigo maligna.
• This may improve patient outcomes by reducing the risk of progression to invasive melanoma.
• Clinicians should consider these findings when evaluating suspicious pigmented lesions on the face.