Lentigo maligna/lentigo maligna melanoma: Current state of diagnosis and treatment
Lentigo maligna/lentigo maligna melanoma: Current state of diagnosis and treatment
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DOI：
10.1111/j.1524-4725.2006.32102.x
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发表时间：
2006-04-01
影响因子：
2.4
通讯作者：
Bowen, GM
中科院分区：
文献类型：
--
作者：
McKenna, JK;Florell, SR;Bowen, GM
恶性小痣（LM）是原位黑素瘤的一种亚型，通常发生在日光损伤的皮肤上。表现可能相当微妙，延误诊断是常见的。临床切缘往往不明确。组织学评估可能是困难的，因为广泛存在的非典型黑色素细胞的背景下，长期的阳光损害。标准治疗后复发是常见的。目的回顾LM的临床特征、组织病理学和治疗选择。重点放在治疗LM的最新进展。方法和材料Literature review.Results LM进展为LM黑色素瘤的估计终生风险为5%。在50%的病例中，LM的标准切除（5 mm边缘）是不够的。标准切除的复发率为8 - 20%。莫氏手术和分期切除可提供更好的边缘控制和更低的复发率（4-5%）。估计复发率以下的非手术治疗，如冷冻，放疗，电灼和刮宫，激光手术，局部用药范围从20至100%，在5 years.CONCLUSIONS充分治疗LM需要一个全面的知识的诊断特征，组织病理学和治疗方案。对组织边缘进行仔细评估的手术方式似乎提供了最低的疾病复发率。
BACKGROUND Lentigo maligna (LM) is a subtype of melanoma in situ that typically develops on sun-damaged skin. Presentation may be quite subtle and delayed diagnosis is common. Clinical margins are often ill defined. Histologic evaluation can be difficult due to the widespread atypical melanocytes that are present in the background of longstanding sun damage. Recurrence following standard therapies is common.OBJECTIVE To review the clinical features, histopathology, and treatment options for LM. Emphasis is placed on recent advances in the treatment of LM.METHODS AND MATERIALS Literature review.RESULTS The estimated lifetime risk of LM progressing to LM melanoma is 5%. Standard excision of LM with 5 mm margins is insufficient in 50% of cases. The recurrence rate with standard excision ranges from 8 to 20%. Mohs surgery and staged excision may offer better margin control and lower recurrence rates (4-5%). Estimates of recurrence rates following nonsurgical therapies such as cryosurgery, radiotherapy, electrodessication and curettage, laser surgery, and topical medications range from 20 to 100% at 5 years.CONCLUSIONS Adequate treatment of LM requires a comprehensive knowledge of the diagnostic features, histopathology, and treatment options. Surgical modalities with meticulous evaluation of tissue margins appears to offer the lowest rates of disease recurrence.