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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.

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.