34 3 Eyelid Neoplasms

LENTIGO MALIGNA L entigo maligna is a flat intraepidermal neoplasm and the precursor lesion of len tigo maligna melanoma. The lesion has strik ing variations of brown and black ( Fig. 3-3 ), often described as a “stain.” Epidemiology and Etiology ● Age: Median age is 65 years. ● Gender: Equal incidence in males and females ● Etiology: Sun exposure is a definite factor. History ● History is usually not helpful, because the exact onset of lesion is unclear. Examination ● Flat, dark brown or black color, sharply defined edges ● Often appears like a dark “stain” on the skin

Special Considerations ● This is a premalignant lesion and should be excised because of the chance of development into a lentigo maligna melanoma. Differential Diagnosis ● Seborrheic keratosis ● Actinic keratosis ● Malignant melanoma Laboratory Tests ● Histopathologic evaluation Treatment ● Excision with margins sent for pathologic evaluation Prognosis ● Excellent if excised before developing into a melanoma

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