Lentigo maligna (LM) of the auricular concha: Confocal microscopy and dermoscopy

Abstract

Dear Editor, Lentigo maligna (LM) is a high-CSD (Cumulative Sun Damage) neoplasia usually diagnosed on sun exposed skin and affecting mostly the elderly patients. Dermoscopy is nowadays one of the most used techniques in identifying LM, differentiating it from solar lentigo or pigmented actinic keratosis, commonly located in the same areas and with a reported sensitivity and specificity of 89% and 96%, respectively. 1 Dermoscopic criteria associated with LM include pigmentation in and around hair follicles (circles and circles within circles), perifollicular gray dots and globules (annular-granular pattern), angulated lines creating rhomboidal structures, and pigmented blotches (homogeneous areas, obliteration of hair follicles). 1,2,3 In the past decade studies have demonstrated that reflectance confocal microscopic (RCM) increases accuracy in the diagnosis of LM with reported specificity of 98.1%, though a low sensibility. 1 The combination of both dermoscopy and RCM could increase significantly the diagnosis accuracy of LM.