ABSTRACT
This chapter presents the case study of a 73-year-old man. A 73-year-old man presents with an 18-month history of a pigmented lesion on his left cheek. He had not paid much attention to it and had assumed it to be a ‘sun spot’; however, his daughter is concerned that it has been enlarging slowly and appears to be getting darker in colour. The patient has a brown to black macular lesion measuring 2 cm in diameter that has a highly irregular border over his left cheek. Clinically the most likely diagnosis is lentigo maligna (LM). Histopathologically, LM is characterized by abnormal melanocytes confined within the epidermis the basement membrane. The definitive treatment of LM is surgical excision. In many patients, however, surgery may not be possible due to other co-morbidities. The development of a papular or nodular element within the LM should lead to a high suspicion of transformation to melanoma.
