Follicular involvement is frequent in lentigo maligna: Implications for treatment Journal Article


Authors: Connolly, K. L.; Giordano, C.; Dusza, S.; Busam, K. J.; Nehal, K.
Article Title: Follicular involvement is frequent in lentigo maligna: Implications for treatment
Abstract: Background: Follicular involvement of lentigo maligna (LM) is considered a histopathologic hallmark, but its prevalence and characteristics have not been well defined. The depth of intrafollicular extension by neoplastic melanocytes may have clinical importance in the treatment of LM. Objective: To describe the prevalence and features of follicular involvement in LM, including depth of follicular growth by melanocytes. Methods: A single-center retrospective study of 100 consecutive cases of surgically excised LM that was treated from 2013 to 2015. The slide review for cases with residual LM on the debulk specimen was performed by a dermatologic surgeon and dermatopathologist to characterize follicular involvement. Results: Of 100 specimens, 72 met the inclusion criteria for histopathologic evaluation. Follicular involvement was seen in 95.8% of specimens (95% confidence interval, 88.3%-99.1%), with a mean of 68% of follicles involved in a single specimen. The mean depth of intrafollicular growth by lesional melanocytes was 0.45 mm (standard deviation, 0.23; range, 0.1-1.1 mm). Tumor cells were confined to the infundibular portion of the hair follicle in 60.9% of specimens. Conclusion: Superficial follicular involvement is a ubiquitous finding in LM. When treatment options for LM with a depth-dependent modality aiming for tumor clearance are being considered, mean and maximum depths of involvement should be taken into consideration. © 2018 American Academy of Dermatology, Inc.
Keywords: major clinical study; histopathology; melanoma; cell growth; lentigo maligna; malignant lentigo; melanocyte; prevalence; retrospective study; tissue section; scalp; neck; ear; follicular carcinoma; forehead; cheek; hair follicle; eyebrow; adnexa; chin; human; priority journal; article; eyelid; follicular involvement
Journal Title: Journal of the American Academy of Dermatology
Volume: 80
Issue: 2
ISSN: 0190-9622
Publisher: Mosby Elsevier  
Date Published: 2019-02-01
Start Page: 532
End Page: 537
Language: English
DOI: 10.1016/j.jaad.2018.07.071
PUBMED: 30266559
PROVIDER: scopus
PMCID: PMC6333487
DOI/URL:
Notes: Article -- Export Date: 1 February 2019 -- Source: Scopus
Altmetric
Citation Impact
BMJ Impact Analytics
MSK Authors
  1. Kishwer S Nehal
    278 Nehal
  2. Stephen Dusza
    288 Dusza
  3. Klaus J Busam
    688 Busam