Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Follicular Involvement Frequent in Lentigo Maligna

J Am Acad Dermatol; ePub 2018 Sep 26; Connolly, et al

Superficial follicular involvement is a ubiquitous finding in lentigo maligna (LM), according to a recent study. Therefore, when considering treatment options for LM with a depth-dependent modality aiming for tumor clearance, mean and maximum depths of involvement should be considered. Researchers conducted a single-center retrospective study of 100 consecutive cases of surgically excised LM treated from 2013 to 2015. Slide review for cases with residual LM on debulk specimen was performed by a dermatologic surgeon and dermatopathologist to characterize follicular involvement. They found:

  • 72 of 100 specimens met inclusion criteria for histopathologic evaluation.
  • Follicular involvement was seen in 95.8% of specimens, with a mean 68% of follicles involved in a single specimen.
  • The mean depth of intrafollicular growth by lesional melanocytes was 0.45 mm (SD=0.23, range 0.1 mm to 1.1 mm).
  • Tumor cells were confined to the infundibular portion of the hair follicle in 60.9% of specimens.
Citation:

Connolly KL, Giordano C, Dusza S, Busam KJ, Nehal K. Follicular involvement is frequent in lentigo maligna: Implications for treatment. [Published online ahead of print September 26, 2018]. J Am Acad Dermatol. doi:10.1016/j.jaad.2018.07.071.

This Week's Must Reads

Dermatomyositis, Negative ANA, and Malignancy Risk, J Am Acad Dermatol; ePub 2018 Nov 17; Hoesly, et al

Head/Neck Melanomas Have High Local Recurrence Risk, J Am Acad Dermatol; ePub 2018 Nov 17; Fix, et al

DOT Laser Offers Low Incidence of Adverse Effects, J Drugs Dermatol; 2018 Nov; Sarnoff, Gotkin, et al

Frontal Fibrosing Alopecia and Severity Factors , Dermatology (Karger); ePub 2018 Nov 22; Mervis, et al

Unsafe Neighborhoods Linked with Higher AD Risk, Ann Allergy Asthma Immunol; ePub 2018 Oct 26; McKenzie, et al

Must Reads in Melanoma

Head/Neck Melanomas Have High Local Recurrence Risk, J Am Acad Dermatol; ePub 2018 Nov 17; Fix, et al

Early Desmoplastic Melanoma Treatment Comparison, Melanoma Res; ePub 2018 Oct 31; Abbott, et al

Melanoma Risk and Moderately Dysplastic Nevi, JAMA Dermatol; ePub Oct 10; Kim, Berry, et al

Predictors of Mucosal Melanoma Survival, J Am Acad Dermatol; ePub 2018 Oct 5; Altieri, et al

Follicular Involvement Frequent in Lentigo Maligna, J Am Acad Dermatol; ePub 2018 Sep 26; Connolly, et al