Dermatológia pre prax 2/2019
Diagnosis of the lentigo maligna and pigmented macules at the facial area
Introduction: Diagnostic of the cutaneous lesions on chronically sun-damaged facial skin is challenging task for dermatologist. Differencial diagnosis may include lentigo maligna, solar lentigo, early seborrheic keratosis, pigmented actinic keratosis, lichen-planus-like keratosis. Dermoscopy in experienced hands can improve diagnostic accuracy. Case: In our case we concentrate on the patient with lentigo maligna on the right part of the nose. We want to emphasize the difficulty with differencial diagnosis of facial pigmented lesions. This is caused not only by the similarity in clinical apperarance of the aforementioned lesions. These lesions can share the same dermoscopic features. Conclusion: In the further text we state clinical as well as dermoscopic criteria of lentigo maligna and similar lesions. Dermoscopic structures associated with lentigo maligna are asymmetric follicular openings, annular-granular pattern, rhomboidal structures, blotches with preserved follicular openings or blotches that obliterate follicular openings. Any doubtful lesion should undergo biopsy.
Keywords: lentigo maligna, solar lentigo, early seborrheic keratosis, pigmented actinic keratosis, lichen-planus-like keratosis, differencial diagnosis, dermoscopic examination
