scholarly journals Diagnosis and Management of Lentigo Maligna: Clinical Presentation and Comprehensive Review

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Piyu Parth Naik
Keyword(s):  
Clinical Presentation ◽  
The Elderly ◽  
Lentigo Maligna ◽  
Diagnosis And Management ◽  
Skin Cancers ◽  
Lentigo Maligna Melanoma ◽  
History Of ◽  
Biopsy Examination ◽  
Available Information

Lentigo maligna (LM), also known as Hutchinson’s melanotic freckle, is a form of in situ melanoma characterized by the proliferation of atypical melanocytes along the basal epidermis in sun-damaged skin. If left untreated, LM will progress to lentigo maligna melanoma (LMM), a form of invasive melanoma with the same prognosis as other forms of invasive melanoma. LM is more common in the elderly, with a peak occurrence between the ages of 65 and 80 years. LM, however, is rarely present on the trunk and extremities. The diagnosis of LM, confirmed by histopathological and biopsy examination, is based on clinical and dermoscopic features. It typically begins as a tan-brown macule or patch, but it can progress to a variegated pigmentation with dark black color or even amelanotic characteristics. The risk factors involved in the LM development include a history of sunburns, lighter skin types, advanced age, history of nonmelanoma skin cancers, and tendency to form solar lentigines. This article explains the clinical presentation of LM, also reviews the available information on the diagnosis and management of LM, and discusses the potential of such information in facilitating the future prospective.

scholarly journals Epidemiological aspects of melanoma at a university hospital dermatology center over a period of 20 years

2013 ◽  
Vol 88 (3) ◽  
pp. 344-353 ◽  
Author(s):  
Flavia Vieira Brandao ◽  
Ana Francisca Junqueira Ribeiro Pereira ◽  
Bernardo Gontijo ◽  
Flavia Vasques Bittencourt
Keyword(s):  
Head And Neck ◽  
Hospital Setting ◽  
Histological Type ◽  
University Hospital ◽  
Lentigo Maligna ◽  
Risk Of Death ◽  
Skin Cancers ◽  
Lentigo Maligna Melanoma ◽  
History Of ◽  
Level Of Significance

BACKGROUND: The incidence of melanoma has been steadily rising in past decades. Although it accounts for only 3% of all skin cancers, it is responsible for 75% of deaths. OBJECTIVE: to describe the epidemiological aspects of melanoma in a university hospital setting over a period of 20 years. METHODS: A total of 166 patients were analyzed between January 1990 and January 2010 for clinical and histological variables and correlations between them. A 5% level of significance was adopted. RESULTS: The majority of patients were Caucasians (74%), females (61%), with a mean age at diagnosis of 55. The predominant histological type was lentigo maligna/lentigo maligna melanoma (35.7%) and the head and neck was the most affected site (30.7%). Among non-Caucasians, the acral region was the most affected. Most tumors were in situ (41.1%). Growth of the lesion was the most frequent complaint (58.1%) and bleeding was most frequently associated with melanomas with a depth > 4mm. There were seven deaths (4.2%), with a high risk among men, non-Caucasians and those under 20 years of age, with a Breslow's depth > 2mm, with lentiginous acral melanoma and with a history of growth and bleeding. CONCLUSIONS: Our sample differs from most of the studies in the predominant location (head and neck), histological type (lentigo maligna/ lentigo maligna melanoma) and a major risk of death under the age of 20, which could be with a reflex of regional variation. Broader studies are necessary for validation of the results.

scholarly journals 651. Comparative Analysis Between Bacterial And Fungal Malignant Otitis Externa

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S383-S384
Author(s):  
Fatma Hammami ◽  
Makram Koubaa ◽  
Amal Chakroun ◽  
Fatma Smaoui ◽  
Khaoula Rekik ◽  
...  
Keyword(s):  
Otitis Externa ◽  
Clinical Presentation ◽  
The Elderly ◽  
Causative Organism ◽  
Diabetic Patients ◽  
Duration Of Treatment ◽  
Evolutionary Features ◽  
Significant Difference ◽  
Malignant Otitis Externa ◽  
History Of

Abstract Background Malignant otitis externa is a fatal infection of the external ear and temporal bone. Pseudomonas aeruginosa is the most common causative organism, while fungi are a rare cause of malignant otitis externa. We aimed to compare the clinical, therapeutic and evolutionary features between bacterial and fungal malignant otitis externa. Methods We conducted a retrospective study including all patients hospitalized for malignant otitis externa in the infectious diseases department between 2000 and 2018. Results Overall, we encountered 82 cases of malignant otitis externa, among which there were 54 cases (65.9%) of bacterial malignant otitis externa (BMO) and 28 cases (34.1%) of fungal malignant otitis externa (FMO). The males were predominant among BMO cases (57.4% vs 50%; p=0.5). Patients with FMO were significantly older (70±9 years vs 61±10 years; p< 0.001) and had medical history of diabetes mellitus more frequently (96.4% vs 77.8%; p=0.03). The use of topical corticosteroids was significantly more reported among FMO cases (28.6% vs 5.6%; p=0.006). Otalgia (96.4% vs 81.5%), otorrhea (75% vs 66.7%) and cephalalgia (46.4% vs 42.6%) were the revealing symptoms among FMO and BMO, respectively, with no significant difference. Tenderness to palpation of the mastoid bone (64.3% vs 38.9%; p=0.02) and stenosis of the external auditory canal (92.9% vs 72.2%; p=0.02) were significantly more frequent among FMO cases. Complications were significantly more frequent among FMO cases (42.9% vs 9.3%; p< 0.001). Treatment duration was significantly longer among FMO cases (70[40-90] days vs 45[34-75] days; p=0.03). Conclusion Our study showed that FMO affected more frequently the elderly and diabetic patients, when compared with BMO. Regardless of the causative agent, the clinical presentation was similar. However, the outcome was poor among FMO cases with the occurrence of complications, requiring a longer duration of treatment. Disclosures All Authors: No reported disclosures

scholarly journals Lentigo maligna and lentigo maligna melanoma: contemporary issues in diagnosis and management

2015 ◽  
Vol 2 (2) ◽  
pp. 171-178
Author(s):  
Karen L Connolly ◽  
Kishwer S Nehal ◽  
Klaus J Busam
Keyword(s):  
Lentigo Maligna ◽  
Diagnosis And Management ◽  
Lentigo Maligna Melanoma

scholarly journals Lentigo maligna melanoma with a history of cosmetic treatment: Prevalence, surgical outcomes and considerations

2017 ◽  
Vol 49 (9) ◽  
pp. 819-826 ◽  
Author(s):  
Brian P. Hibler ◽  
Karen L. Connolly ◽  
Erica H. Lee ◽  
Anthony M. Rossi ◽  
Kishwer S. Nehal
Keyword(s):  
Surgical Outcomes ◽  
Lentigo Maligna ◽  
Treatment Prevalence ◽  
Lentigo Maligna Melanoma ◽  
History Of

scholarly journals Olmesartan-Induced Enteropathy: A Case of Recurrent Diarrhoea

2020 ◽  
Author(s):  
Ana Rita Matos ◽  
Elisabete Coelho ◽  
Sofia Caridade
Keyword(s):  
Clinical Presentation ◽  
Villous Atrophy ◽  
Kidney Injury ◽  
Duodenal Mucosa ◽  
Outpatient Basis ◽  
Antibody Testing ◽  
Blood Tests ◽  
History Of ◽  
Biopsy Examination ◽  
Previous Admission

A 77-year-old man with arterial hypertension and dyslipidaemia, treated with olmesartan/hydrochlorothiazide and simvastatin, was admitted with a 3-week history of anorexia, nausea, vomiting, profuse diarrhoea and weight loss. He was dehydrated and blood tests showed acute kidney injury. The aetiological study was inconclusive. The patient had a favourable clinical evolution during hospitalization and was discharged. However, after about 10 days at home, he was re-admitted to hospital with the same clinical presentation. It was noticed that olmesartan had not been prescribed during the previous admission but had been restarted on an outpatient basis. Biopsy examination showed duodenal mucosa with villous atrophy and polymorphic inflammatory infiltrate. Antibody testing for coeliac disease was negative. Based on these facts, it was hypothesized that the patient had olmesartan-induced enteropathy, which was subsequently confirmed.

The elderly patient

2013 ◽  
Author(s):  
Fraser Birrell ◽  
Janice O’Connell
Keyword(s):  
Elderly Patient ◽  
United Kingdom ◽  
Older Patients ◽  
Clinical Presentation ◽  
The Elderly ◽  
Diagnosis And Treatment ◽  
Musculoskeletal Conditions ◽  
Diagnosis And Management ◽  
The United Kingdom ◽  
Rheumatological Diseases

In this chapter, we describe how the process of ageing can itself affect the diagnosis and treatment of musculoskeletal conditions. We outline general principles concerning the clinical presentation of rheumatological diseases in older patients, as well as providing specific guidance on the diagnosis and management of the commoner conditions encountered in practice in the United Kingdom.

Melanoma in situ/Lentigo maligna: Wo und bei wem sollte ich darauf achten?

2019 ◽  
Vol 7 (2) ◽  
pp. 67-68
Author(s):  
Jan Maschke
Keyword(s):  
Demographic Data ◽  
Anatomical Location ◽  
Lentigo Maligna ◽  
Large Patch ◽  
Melanoma In Situ ◽  
Median Diameter ◽  
The Face ◽  
History Of ◽  
Full Body

Introduction: Lentigo maligna (LM) is a rare form of in situ melanoma, frequently seen as a large patch in elderly patients. The aim of this study was to assess clinical and dermoscopic features of LM. Material and Methods: A retrospective study of LM patients presenting to our center between July 2007 and July 2017 was performed. Demographic data, anatomical location, laterality, diameter, Clark level, Breslow stage, ‘ABCD' signs and dermoscopic features were registered. Facial versus extrafacial LM were compared. Results: We found 21 LM, of which 12 had an extrafacial location and 9 a facial location. Half of the extrafacial lesions were located on an upper limb. The median age at diagnosis was 63 years (ranging from 38 to 84 years). Most LM cases were female (16/21) with phototype II (13/21). More than half of the patients (11/21) had a history of a skin neoplasm or actinic keratosis. The median diameter found was 6 mm (interquartile range = 4.5 mm), ranging from 1 to 15 mm. Five lesions were invasive (median Breslow depth of 0.2 mm), and 4 of them were extrafacial. Discussion: In this study LM was more frequently found in an extrafacial location and as a small patch with a 6-mm diameter medium. The epidemiology of LM/LM melanoma might be changing. Full body examination and dermoscopy are of the utmost importance for the diagnosis. Dermatologists should be aware and search for small lesions outside the face and neck, particularly in middle-aged female patients with photo-damaged skin.

Lentigo Maligna: Melanoma In Situ on Chronically Sun-Damaged Skin

2011 ◽  
Vol 135 (7) ◽  
pp. 838-841
Author(s):  
Jon A. Reed ◽  
Christopher R. Shea
Keyword(s):  
Review Of The Literature ◽  
Lentigo Maligna ◽  
Superficial Spreading ◽  
Anatomic Site ◽  
Classification Schemes ◽  
Melanoma In Situ ◽  
Personal Experiences ◽  
Lentigo Maligna Melanoma ◽  
Histologic Subtypes

Abstract Context.—Cutaneous primary invasive malignant melanoma often is classified by its histologic appearance. Major recognized histologic subtypes of melanoma include superficial spreading, lentigo maligna melanoma, nodular, and acral lentiginous. More recently, it has been shown that most primary invasive melanomas harbor nonrandom genetic or biochemical aberrations that correlate with anatomic site or with the amount of cutaneous exposure to sunlight. It also is generally accepted that most primary invasive melanomas are preceded by an intraepidermal atypical melanocytic proliferation that lacks invasive capability (melanoma in situ). Objective.—To focus on lentigo maligna, the preinvasive/in situ form of melanoma located on chronically sun-damaged skin. Data Sources.—Review of the literature and the authors' personal experiences. Conclusions.—A better understanding of the earliest stage of melanoma progression, including the contribution of chronic exposure to ultraviolet radiation, may lead to improved classification schemes that direct more effective targeted or personalized therapies for patients.

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