Background: Lentigo maligna (LM) and lentigo maligna-melanoma (LMM) are histotypes of melanoma arising in skin with cumulative solar radiation damage. The extension of atypical melanocytes to the hair follicle (folliculotropism) is a histopathological feature of LM/LMM. Its role has not been totally clarified, but it may be correlated to treatment response in LM or to progression in LMM. Objective: This retrospective, multicentric study aims to identify dermatoscopic features associated with folliculotropism in LMs/LMMs. Patients and methods: We analyzed cases of head and neck LMs/LMMs diagnosed between 2005-2014 at Melanoma Units, University of Bologna/Modena/Florence/Siena (Italy), Nice (France): 25 LMs and 73 LMMs were included. Results: Grey circles (44 %) indicated an isthmic/bulb level of involvement, which were completely absent in the infundibular LM lesions (P = 0.041). In the group of LMMs, light/dark brown pseudonetwork and light brown structureless areas were an indicator of diffuse distribution of malignant melanocytes in the follicular units (P < 0.001 and P = 0.001, respectively), while grey circles indicated focal or diffuse distribution (P < 0.001). Conclusions: A better understanding of the extension of malignant melanocytes is helpful, aiding clinicians in their decision to perform a radical excision or obtaining a biopsy in the most invasive area of the lesion, which includes potential folliculotropism.
Folliculotropism in head and neck lentigo maligna and lentigo maligna melanoma / Dika, Emi; Lambertini, Martina; Patrizi, Annalisa; Misciali, Cosimo; SCARFì, Federica; Pellacani, Giovanni; Mandel, Victor Desmond; Di Tullio, Francesca; Stanganelli, Ignazio; Chester, Johanna; Kaleci, Shaniko; Massi, Daniela; De Giorgi, Vincenzo; Cinotti, Elisa; Rubegni, Pietro; Perrot, Jean-Luc; Farnetani, Francesca. - In: JOURNAL DER DEUTSCHEN DERMATOLOGISCHEN GESELLSCHAFT. - ISSN 1610-0379. - 19:2(2021), pp. 223-229. [10.1111/ddg.14311]
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