Flat pigmented macules on sun-damaged skin of the head/neck: Junctional nevus, atypical lentiginous nevus, or melanoma in situ?

Iris Zalaudek, Carlo Cota, Gerardo Ferrara, Elvira Moscarella, Pascale Guitera, Caterina Longo, Simonetta Piana, Giuseppe Argenziano

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

The clinical recognition of lentigo maligna (LM) in the mottled chronic sun-damaged skin can be challenging, because it shares many clinical features with other pigmented macules that commonly arise on sun-damaged skin. These include solar lentigo, flat seborrheic keratosis, and pigmented actinic keratosis, but almost never "nevus." The reason nevus is not included in the differential diagnosis of LM can be explained by the fact that the stereotypical appearance of a facial nevus differs remarkably from that of an LM. Facial nevi in adults are usually nodular, dome-shaped, well-defined, and hypopigmented (ie, intradermal nevus of the Miescher type), whereas LM typically appears as a flat, ill-defined, and pigmented macule. Although this concept based on clinical observations sounds reasonable, clinicians apply it often only unconsciously and accept a given histopathologic diagnosis of a "junctional or lentiginous nevus" of a flat pigmented facial macule without the necessary criticism about its clinicopathologic validity.

Original languageEnglish
Pages (from-to)88-93
Number of pages6
JournalClinics in Dermatology
Volume32
Issue number1
DOIs
Publication statusPublished - Jan 2014

Fingerprint

Nevi and Melanomas
Hutchinson's Melanotic Freckle
Nevus
Solar System
Neck
Head
Skin
Intradermal Nevus
Seborrheic Keratosis
Lentigo
Actinic Keratosis
Differential Diagnosis

ASJC Scopus subject areas

  • Dermatology

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Flat pigmented macules on sun-damaged skin of the head/neck : Junctional nevus, atypical lentiginous nevus, or melanoma in situ? / Zalaudek, Iris; Cota, Carlo; Ferrara, Gerardo; Moscarella, Elvira; Guitera, Pascale; Longo, Caterina; Piana, Simonetta; Argenziano, Giuseppe.

In: Clinics in Dermatology, Vol. 32, No. 1, 01.2014, p. 88-93.

Research output: Contribution to journalArticle

Zalaudek, Iris ; Cota, Carlo ; Ferrara, Gerardo ; Moscarella, Elvira ; Guitera, Pascale ; Longo, Caterina ; Piana, Simonetta ; Argenziano, Giuseppe. / Flat pigmented macules on sun-damaged skin of the head/neck : Junctional nevus, atypical lentiginous nevus, or melanoma in situ?. In: Clinics in Dermatology. 2014 ; Vol. 32, No. 1. pp. 88-93.
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