Summer is approaching and as we are planning beautiful outdoors activities, we are concern about how much sun is safe for our skin. Ultraviolet radiation exposure is reflected in our skin as sun damage. Certainly sun avoidance, appropriate sun protection and regular skin checks will prevent the appearance of the so called “sun spots”, freckles, and also reduce the risk of developing non-melanoma skin cancers and melanoma.
Lentigomaligna (LM) is an in-situ (superficial) melanoma, commonly presenting on sun-exposed areas (e.g. the face) as an irregular dark pigmentation. Historically, the name of “Hutchinson Melanoma Freckle” was given, after Sir John Hutchinson who described the first case of lentigomaligna in 1890. Currently, there is preference to call this entity as LM, to differentiate it from the benign term freckle. LM it is highly associated to sun exposure, has a long-standing history, where colours and shape change without being noticeable to the human eye. As it grows superficially normally, it becomes a problem when its very extensive and when the borders of the lesion are difficult to demarcate.
It is important to mention that not all pigmentations on the face are to worry about but subtle or noticeable changes in pigmentation, shape or size or new onset of pigmentation require medical advice. Always ask for a referral to see a Dermatologist if you are concerned about it.
To sum up, in the unfortunate case of a pigmentation being suspicious for malignancy, your doctor or specialist will recommend a biopsy (sample of skin). Some doctors/specialist prefer to send their patients to have reflectance confocal microscopy before a biopsy is performed. This non-invasive imaging technique aids to look at the superficial layers of skin in a very similar matter as histopathology does. In other words it is like a virtual biopsy. Different treatments are available for LM and these include: surgical excision, radiotherapy and topicals such as imiquimod.
Dr. Giuliana Carlos
1st Year Dermatology Registrar
Our Corporate Skin Check Program offers an easy and convenient way for companies to organise full skin cancer checks for staff by our expert skin doctors from The Skin Hospital, a divsion of the Skin & Cancer Foundation Australia.
Our medical team will come to your workplace to conduct a full body skin check.