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Lentigo maligna

Synonyms: Lentigo-maligna-Melanom, LMM

By Dr. Pascal Bafteh · last updated 09/2026

Lentigo maligna: Irregularly pigmented, approximately 2×1 cm brown patch on the left cheek. — Omar Bari, Philip R. Cohen, „Photograph of lentigo maligna melanoma", CC BY 3.0, via Wikimedia Commons · CC BY 3.0 · Source

Lentigo maligna: unregelmäßig pigmentierte, unscharf begrenzte Macula auf chronisch lichtgeschädigter Haut. (Foto: kilbad (talk), Wikimedia Commons, CC BY 3.0) — kilbad (talk), „Lentigo maligna“, CC BY 3.0, via Wikimedia Commons · CC BY 3.0 · Source

Lentigo Maligna (LM) and Lentigo Maligna Melanoma (LMM)

Definition: Lentigo maligna is a melanoma in situ on chronically sun-damaged skin; only once the basement membrane is breached is it called lentigo maligna melanoma.
Clinical picture: a slowly enlarging, ill-defined, irregularly brown-black macule on the chronically sun-exposed face of older patients (cheek, temple, nose).
Diagnostics: Because of the surface area and the cosmetically sensitive site, start with a punch biopsy from the clinically and dermoscopically most conspicuous area — otherwise an invasive component is missed.
Therapy: In situ disease with a 5 mm safety margin, LMM adapted to Breslow thickness; on the face preferably micrographically controlled surgery. If inoperable, radiotherapy and off-label imiquimod are available.

Differential diagnoses

Melanoma
Actinic keratosis
Basal cell carcinoma
Dysplastic naevus
Solar lentigo
Seborrhoeic keratosis

Practise Lentigo maligna in the app

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In the DermaFuchs app: 2 flashcards · 9 clinical images

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Sources (selection)

Leitlinienprogramm Onkologie (German Cancer Society, German Cancer Aid, AWMF). S3 guideline on diagnosis, therapy and follow-up of melanoma. Version 3.3. AWMF registry no. 032/024OL. 2020.

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Note: This page is intended for medical education and does not replace diagnosis or treatment decisions in individual cases. Treatment and follow-up content is available in the app.