We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editorial |

Lentigo Maligna One Size Does Not Fit All

Glen M. Bowen, MD; Anneli R. Bowen, MD; Scott R. Florell, MD
Arch Dermatol. 2011;147(10):1211-1213. doi:10.1001/archdermatol.2011.234.
Text Size: A A A
Published online


The diagnosis and treatment of lentigo maligna (LM) present challenges to the dermatopathologist and clinician, who struggle to make an accurate diagnosis, devise a treatment plan appropriate to the age and health status of the patient, and determine when surgical margins are truly negative. All these issues create complexity when managing an increasingly common tumor.1 Because most LM lesions occur in cosmetically sensitive areas —usually on the head and neck2 —surgical morbidity is an unavoidable consequence of staged excisions with relatively large defects. When confronted with an ambiguous pathology report, such as “atypical junctional melanocytic hyperplasia with severe atypia on sun-damaged skin ” or “evolving melanoma in situ, ” the clinician is caught on the horns of a dilemma: is this LM or not? If so, what treatment approach strikes the appropriate balance between the relatively low risk of the tumor becoming invasive (if the LM began when the patient was 65 years old, the estimated lifetime risk is 3.3%)3 vs the morbidity of a large staged excision? When it comes to treatment, if ever there was a tumor for which one size does not fit all, it is LM.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

5 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Collections
PubMed Articles