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Delphi Consensus Among International Experts on the Diagnosis, Management, and Surveillance for Lentigo Maligna

Longo, C. (author)
Navarrete-Dechent, C. (author)
Tschandl, P. (author)
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Apalla, Z. (author)
Argenziano, G. (author)
Braun, R. P. (author)
Bataille, V. (author)
Cabo, H. (author)
Hoffmann-Wellhenhof, R. (author)
Forsea, A. M. (author)
Garbe, C. (author)
Guitera, P. (author)
Raimond, K. (author)
Marghoob, A. A. (author)
Malvehy, J. (author)
Del Marmol, V. (author)
Moreno, D. (author)
Nehal, K. S. (author)
Nagore, E. (author)
Paoli, John, 1975 (author)
Gothenburg University,Göteborgs universitet,Institutionen för kliniska vetenskaper, Avdelningen för dermatologi och venereologi,Institute of Clinical Sciences, Department of Dermatology and Venereology
Pellacani, G. (author)
Peris, K. (author)
Puig, S. (author)
Soyer, H. P. (author)
Swetter, S. (author)
Stratigos, A. (author)
Stolz, W. (author)
Thomas, L. (author)
Tiodorovic, D. (author)
Zalaudek, I. (author)
Kittler, H. (author)
Lallas, A. (author)
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 (creator_code:org_t)
2023
2023
English.
In: Dermatology Practical & Conceptual. - 2160-9381. ; 13:3
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  • Journal article (peer-reviewed)
Abstract Subject headings
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  • Introduction: Melanoma of the lentigo maligna (LM) type is challenging. There is lack of consensus on the optimal diagnosis, treatment, and follow-up. Objectives: To obtain general consensus on the diagnosis, treatment, and follow-up for LM. Methods: A modified Delphi method was used. The invited participants were either members of the International Dermoscopy Society, academic experts, or authors of published articles relating to skin cancer and melanoma. Participants were required to respond across three rounds using a 4-point Likert scale). Consensus was defined as >75% of participants agreeing/strongly agreeing or disagreeing/strongly disagreeing. Results: Of the 31 experts invited to participate in this Delphi study, 29 participants completed Round 1 (89.9% response rate), 25/31 completed Round 2 (77.5% response rate), and 25/31 completed Round 3 (77.5% response rate). Experts agreed that LM diagnosis should be based on a clinical and dermatoscopic approach (92%) followed by a biopsy. The most appropriate primary treatment of LM was deemed to be margin-controlled surgery (83.3%), although non-surgical modalities, especially imiquimod, were commonly used either as alternative off-label primary treatment in selected patients or as adjuvant therapy following surgery; 62% participants responded life-long clinical follow-up was needed for LM. Conclusions: Clinical and histological diagnosis of LM is challenging and should be based on macroscopic, dermatoscopic, and RCM examination followed by a biopsy. Different treatment modalities and follow-up should be carefully discussed with the patient.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Dermatologi och venereologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Dermatology and Venereal Diseases (hsv//eng)

Keyword

melanoma
lentigo maligna
Delphi
diagnosis
management

Publication and Content Type

ref (subject category)
art (subject category)

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