Melanoma on chronically sun-damaged skin: Lentigo maligna and desmoplastic melanoma.

DeWane, Madeline E; Kelsey, Andrew; Oliviero, Margaret; Rabinovitz, Harold; Grant-Kels, Jane M

DeWane, Madeline E; Kelsey, Andrew; Oliviero, Margaret; Rabinovitz, Harold; Grant-Kels, Jane M.

Afiliación

DeWane ME; University of Connecticut School of Medicine, Farmington, Connecticut.
Kelsey A; Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut. Electronic address: akelsey@uchc.edu.
Oliviero M; Dermatology Associates, Plantation, Florida.
Rabinovitz H; Dermatology Associates, Plantation, Florida.
Grant-Kels JM; Department of Dermatology, University of Connecticut Health Center, Farmington, Connecticut.

J Am Acad Dermatol ; 81(3): 823-833, 2019 Sep.

Article en En | MEDLINE | ID: mdl-30930085

RESUMEN

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.

Asunto(s)

Peca Melanótica de Hutchinson/diagnóstico; Neoplasias Cutáneas/diagnóstico; Piel/patología; Luz Solar/efectos adversos; Antígeno B7-H1/genética; Biopsia; Procedimientos Quirúrgicos Dermatologicos; Dermoscopía; Diagnóstico Diferencial; Humanos; Peca Melanótica de Hutchinson/etiología; Peca Melanótica de Hutchinson/terapia; Imiquimod/uso terapéutico; Inmunoterapia/métodos; Márgenes de Escisión; Microscopía Confocal; Tasa de Mutación; Invasividad Neoplásica/genética; Invasividad Neoplásica/patología; Neurofibromina 1/genética; Proteínas Proto-Oncogénicas c-kit/genética; Radioterapia Adyuvante; Ensayos Clínicos Controlados Aleatorios como Asunto; Piel/diagnóstico por imagen; Piel/efectos de la radiación; Envejecimiento de la Piel/patología; Envejecimiento de la Piel/efectos de la radiación; Neoplasias Cutáneas/etiología; Neoplasias Cutáneas/terapia; Resultado del Tratamiento

Palabras clave

dermoscopy; desmoplastic melanoma; lentigo maligna melanoma; melanoma; reflectance confocal microscopy; sun-damaged skin

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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Piel / Neoplasias Cutáneas / Luz Solar / Peca Melanótica de Hutchinson Tipo de estudio: Clinical_trials / Diagnostic_studies / Etiology_studies / Prognostic_studies Límite: Humans Idioma: En Revista: J Am Acad Dermatol Año: 2019 Tipo del documento: Article Pais de publicación: Estados Unidos

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