title: Melanoma of the lentigo maligna subtype:  diagnostic challenges and current treatment paradigms.
abstract: Melanoma of the lentigo maligna subtype presents diagnostic and treatment challenges because of ill-defined clinical margins in cosmetically and functionally sensitive areas of the head and neck with extensive sun damage. This review highlights the natural history, varied clinical presentations, and pitfalls in histologic diagnosis. The focus is on the surgical management, comparing excision and pathologic tissue processing techniques of wide excision, Mohs micrographic surgery, and staged excision. Staged excision is recommended for optimal surgical margin control. Nonsurgical treatment modalities are also reviewed for the elderly or unresectable cases.
authors.affiliation: New York, N.Y. From the Memorial Sloan-Kettering Cancer Center.
authors.forename: Lindsay K
authors.initials: LK
authors.lastname: McGuire
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Disa
authors.forename: Erica H
authors.initials: EH
authors.lastname: Lee
authors.forename: Klaus J
authors.initials: KJ
authors.lastname: Busam
authors.forename: Kishwer S
authors.initials: KS
authors.lastname: Nehal
mesh_terms: D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000473:pathology* / Q000601:surgery*; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*