TY - JOUR
T1 - Melanoma on chronically sun-damaged skin
T2 - Lentigo maligna and desmoplastic melanoma
AU - DeWane, Madeline E.
AU - Kelsey, Andrew
AU - Oliviero, Margaret
AU - Rabinovitz, Harold
AU - Grant-Kels, Jane M.
N1 - Publisher Copyright:
© 2019 American Academy of Dermatology, Inc.
PY - 2019/9
Y1 - 2019/9
N2 - There are multiple, genetically distinct pathways that give rise to melanoma. Melanomas on sun-damaged skin (MSDS), including lentigo maligna and desmoplastic melanoma, have distinct genetic profiles and are uniquely linked to chronic ultraviolet exposure. In this article, we discuss the etiologies of lentigo maligna and desmoplastic melanoma, emerging diagnostic adjuncts that might be helpful for accurately identifying these lesions, and the clinical relevance of their frequent co-occurrence. We present unique and overlapping features of these entities and discuss challenges in MSDS management, including margin assessment, excision, and the potential role of nonsurgical therapy. Last, we address the role of immunotherapy in invasive disease. Understanding MSDS as distinct from melanoma arising on intermittently sun-exposed or sun-protected skin will ultimately help optimize patient outcomes.
AB - There are multiple, genetically distinct pathways that give rise to melanoma. Melanomas on sun-damaged skin (MSDS), including lentigo maligna and desmoplastic melanoma, have distinct genetic profiles and are uniquely linked to chronic ultraviolet exposure. In this article, we discuss the etiologies of lentigo maligna and desmoplastic melanoma, emerging diagnostic adjuncts that might be helpful for accurately identifying these lesions, and the clinical relevance of their frequent co-occurrence. We present unique and overlapping features of these entities and discuss challenges in MSDS management, including margin assessment, excision, and the potential role of nonsurgical therapy. Last, we address the role of immunotherapy in invasive disease. Understanding MSDS as distinct from melanoma arising on intermittently sun-exposed or sun-protected skin will ultimately help optimize patient outcomes.
KW - dermoscopy
KW - desmoplastic melanoma
KW - lentigo maligna melanoma
KW - melanoma
KW - reflectance confocal microscopy
KW - sun-damaged skin
UR - http://www.scopus.com/inward/record.url?scp=85067525864&partnerID=8YFLogxK
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U2 - 10.1016/j.jaad.2019.03.066
DO - 10.1016/j.jaad.2019.03.066
M3 - Review article
C2 - 30930085
AN - SCOPUS:85067525864
SN - 0190-9622
VL - 81
SP - 823
EP - 833
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 3
ER -