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Image Number 1002 (Lentigo maligna melanoma (LMM))

Macule brown

Diagnosis: Lentigo maligna melanoma (LMM)

Site: Face

Sex: M

Age: 70

Type: Clinical

Description: Large, flat, brownish-blackish patch with irregular border and central red nodule.

Submitted by: Nameer Al-Sudany

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Differential Diagnosis


Lentigo maligna is a precancerous condition. It is usually found on chronically sun-exposed skin, usually the face, and has a long preinvasive period. During this phase, the names lentigo maligna (melanoma in situ) is appropriate. After a variable period of time, invasion into the underlying dermis will take place and at this stage it is given the name lentigo maligna melanoma. Initially, lentigo maligna presents as a large flat, brown or black, irregularly shaped lesion that will grow very slowly, over months or years, and there may be central regression while the peripheral margin continues to extend. In time, a raised central nodule will develop indicating transition to the vertical growth phase. This man has had lentigo melanoma since 30 years, at last 6 months a red nodule developed in the center of the lesion which may signal transition into malignant melanoma. Biopsy of the newly appeared nodule was arranged and awaiting the results.

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