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John William Kelly, MD, BS, FACD

Arch Dermatol. 1992;128(5):657-660.

Abstract
• Background.—
Management of lentigo maligna (Hutchinson's melanotic freckle, in situ lentigo maligna melanoma) by regular observation relies on the detection of invasive melanoma before it has developed significant life-threatening potential. Recent studies indicate that lentigo maligna melanoma does not have a better prognosis than other forms of melanoma.

Observations.—
A case is reported of an amelanotic lentigo maligna that evolved from a macular lesion to a deeply invasive, amelanotic, lentigo maligna melanoma within 6 months. The melanoma was Clark level IV and measured 3.0 mm in maximum tumor thickness.

Conclusions.—
Observation of lentigo maligna at 6-month intervals would not seem to be sufficiently reliable in detecting the development of invasive lentigo maligna melanoma before it becomes a life-threatening disease. Early surgical excision is the treatment of choice.

(Arch Dermatol. 1992;128:657-660)

Author Affiliations
From the Dermatology Unit and Monash University Department of Medicine, Alfred Hospital, Melbourne, Australia.

Footnotes
Accepted for publication October 9, 1991.

Reprints not available.

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