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Correspondence |

Lentigo Maligna Melanoma With Folliculotropism: Dermoscopic Features During Rapid Progression

Isil Kilinc-Karaarslan, MD; Taner Akalin, MD; Fezal Ozdemir, MD
Arch Dermatol. 2009;145(6):725-726. doi:10.1001/archdermatol.2009.101.
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Classically, lentigo maligna (LM) may be present for years before it demonstrates dermal invasion and becomes LM melanoma (LMM). Follicular melanoma (FM) is a rare form of melanoma distinguished from LMM by having shorter duration and much smaller lesions (<0.5 cm in diameter) that are relatively symmetric.1

Hantschke  MMentzel  TKutzner  H Follicular malignant melanoma: a variant of melanoma to be distinguished from lentigo maligna melanoma. Am J Dermatopathol 2004;26 (5) 359- 363
PubMed Link to Article[[XSLOpenURL/10.1097/00000372-200410000-00002]]
Stolz  WSchiffner  RBurgdorf  WH Dermatoscopy for facial pigmented skin lesions. Clin Dermatol 2002;20 (3) 276- 278
PubMed Link to Article[[XSLOpenURL/10.1016/S0738-081X(02)00221-3]]
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Figure 1.

Images of the lesion. A, Follicular openings surrounded by a rim of hyperpigmentation, 1 asymmetric follicular opening (red arrow), and 1 rhomboidal structure (black arrow) seen dermoscopically at the patient's first visit. B, Eight months later, the lesion is enlarged and shows increased pigmentation, apparent homogeneous areas, and obliterated hair follicles dermoscopically. Inset, Clinical image from the second visit; asymmetric light and dark brown macular lesions are visible on the nose.

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Figure 2.

Histopathologic images. A, Folliculocentric arrangement of the tumor (hematoxylin-eosin, original magnification ×40). B, Enlargement of the invasive part (hematoxylin-eosin, original magnification ×200). C, Sequential fragment and section of the lesion showing consecutive melanocytic proliferation involving the follicular structure (hematoxylin-eosin, original magnification ×100). D, Prominent melanocytic proliferation at the basilar layer is highlighted (HMB-45–AEC chromogen stain [Dako, Carpinteria, California], original magnification ×100).

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