Journal of cutaneous medicine and surgery · 2026
Lentigo Maligna and Lentigo Maligna Melanoma in Young Patients: What to Expect From the Unexpected?
СтатьяНазвание и аннотация: Перевод в очереди
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Menendez-Sanchez Marta, Gamo-Villegas Reyes, Floristán-Muruzabal María Uxua, Alonso-Cañas Claudia, Pampín-Franco Ana, Sarró-Fuente Claudia, Pinedo-Moraleda Fernando, Pérez-Fernández Elia, López-Estebaranz José Luis
Аннотация
BACKGROUND: Lentigo maligna (LM), traditionally observed in older adults, is increasingly reported among younger patients, in whom diagnostic suspicion is lower.
OBJECTIVE: To characterize clinical, dermoscopic, and reflectance confocal microscopy (RCM) features of LM in patients under and over 50 years of age.
METHODS: This retrospective, single-centre study analyzed 200 patients with 229 biopsy-confirmed LM lesions diagnosed between 2018 and 2023. Patients were stratified by age (<50 vs ≥50 years). Clinical presentation, dermoscopic features, and RCM findings were analyzed using chi-square, Mann-Whitney U tests, and linear regression (P < .05).
RESULTS: Of 229 lesions, 33 occurred in patients <50 years. Younger patients, predominantly female (57% vs 40%, P = .067), showed less chronic actinic damage (41% vs 83%, P < .001) and more frequent trunk (36%) or lower limb (31%) lesions compared to older patients (face/neck 26.7%, trunk 40%, P = .004). Lesions in younger patients tended to be more clinically noticeable and solitary, but showed fewer dermoscopic features (mean 3.26 vs 6.92, P < .001). The 4 most common dermoscopic patterns-central featureless areas, irregular pigmentation foci, asymmetrical follicular pigmentation, and angular lines-though less frequent in younger patients, remain useful for early LM diagnosis. All lesions displayed at least 1 atypical colour, with dark brown being the most frequent (87%). RCM (23 younger, 145 older patients) revealed cytoarchitectural atypia. Invasion rates (21.2% vs 22.6%, P = .86) were similar.
CONCLUSION: LM in younger patients presents as clinically prominent but dermoscopically subtle lesions, necessitating heightened suspicion. The use of RCM may be of value to ensure accurate diagnosis and avoid inappropriate treatments.
OBJECTIVE: To characterize clinical, dermoscopic, and reflectance confocal microscopy (RCM) features of LM in patients under and over 50 years of age.
METHODS: This retrospective, single-centre study analyzed 200 patients with 229 biopsy-confirmed LM lesions diagnosed between 2018 and 2023. Patients were stratified by age (<50 vs ≥50 years). Clinical presentation, dermoscopic features, and RCM findings were analyzed using chi-square, Mann-Whitney U tests, and linear regression (P < .05).
RESULTS: Of 229 lesions, 33 occurred in patients <50 years. Younger patients, predominantly female (57% vs 40%, P = .067), showed less chronic actinic damage (41% vs 83%, P < .001) and more frequent trunk (36%) or lower limb (31%) lesions compared to older patients (face/neck 26.7%, trunk 40%, P = .004). Lesions in younger patients tended to be more clinically noticeable and solitary, but showed fewer dermoscopic features (mean 3.26 vs 6.92, P < .001). The 4 most common dermoscopic patterns-central featureless areas, irregular pigmentation foci, asymmetrical follicular pigmentation, and angular lines-though less frequent in younger patients, remain useful for early LM diagnosis. All lesions displayed at least 1 atypical colour, with dark brown being the most frequent (87%). RCM (23 younger, 145 older patients) revealed cytoarchitectural atypia. Invasion rates (21.2% vs 22.6%, P = .86) were similar.
CONCLUSION: LM in younger patients presents as clinically prominent but dermoscopically subtle lesions, necessitating heightened suspicion. The use of RCM may be of value to ensure accurate diagnosis and avoid inappropriate treatments.