Baylor College of Medicine, One Baylor Plaza, Houston, TX, USA,
Am J Clin Dermatol. 2013 Dec;14(6):473-80. doi: 10.1007/s40257-013-0044-6.
Lentigo maligna is a melanocytic neoplasm, often regarded as 'melanoma in situ,' which may progress to lentigo maligna melanoma. Lentigo maligna clinically presents as a pigmented, asymmetric macule that originates on the head and neck and spreads slowly. The preferred method for diagnosing lentigo maligna is excisional biopsy. Histology shows proliferation of atypical melanocytes at the epidermal-dermal junction in small nests or single cells. The differential diagnosis includes solar lentigo, seborrheic keratosis, lichen planus-like keratosis, pigmented actinic keratosis, and melanocytic nevus. Stains used in diagnosis include hematoxylin and eosin, HMB-45, MART-1/Melan-A, Mel-5, and S-100. Surgical excision is the preferred treatment for lentigo maligna. Second-line techniques include medical (topical imiquimod) and destructive therapy.
恶性雀斑样痣是一种黑色素细胞肿瘤，通常被视为“原位黑色素瘤”，可能进展为恶性雀斑样痣黑色素瘤。恶性雀斑样痣临床上表现为色素沉着、不对称的斑片，起源于头部和颈部，缓慢扩散。诊断恶性雀斑样痣的首选方法是切除活检。组织学显示在小巢或单个细胞中表皮-真皮交界处的不典型黑色素细胞增生。鉴别诊断包括日光性雀斑、脂溢性角化病、扁平苔藓样角化病、色素性光化性角化病和黑色素细胞痣。诊断中使用的染色剂包括苏木精和伊红、HMB-45、MART-1/Melan-A、Mel-5 和 S-100。手术切除是恶性雀斑样痣的首选治疗方法。二线技术包括药物（局部咪喹莫特）和破坏性治疗。
