Dr Stevens explains the advantages of using the latest diagnostic technology, not least confocal microscopy.
Skincare Network are the only private UK dermatology clinic with a reflectance confocal microscope. A tool which increases accuracy, reduces biopsies, helps identify precise treatment options for lentigo maligna patients and lessen scarring from surgery.
As the name suggests, lentigo maligna is early stage malignant melanoma, where cancerous cells are confined to the epidermis, the upper skin layer. In appearance a slowly growing patch of discoloured skin, similar to freckles, or brown sun spots.
Sun damage is the main cause and the discoloured areas can grow to several centimetres over time, perhaps unsightly but not in themselves always dangerous.
They are often referred to as an ‘in situ’ melanoma and only becomes potentially life threatening if developing into lentigo maligna melanoma. Where the condition spreads to the dermis, the deeper layers of your skin.
Transformation to lentigo maligna melanoma is not common and mainly occurs in larger lesions. Detailed, professional examination is still essential.
Consultation & Diagnosis
Lentigo maligna are often irregular in shape and vary in colour, although not normally skin colour. Where there is no penetration to the dermis, cosmetic reasons for removal can matter, along with a need to prevent deeper issues occurring.
One of our consultant dermatologists will examine the lesion(s), with a skilled eye and often with a dermascope. A hand held, skin surface microscope, with a built in, high resolution camera.
A need to take one, or more small biopsies is possible, although as mentioned earlier, at Skin Care Network we often use an alternative to examine layers of your skin at cellular level.
All imagery, or tissue analysis of any type, needs to be allied with the experience of your consultant. Reflectance confocal microscopy is nevertheless a remarkable advance, to avoid biopsies and support treatment.
A small scale study (October 2017) at the Memorial Sloan Kettering Cancer Center in New York focused on lentigo maligna and the use of confocal imaging.
They particularly noted improved accuracy in detecting the margin of healthy skin needing to be removed. Apart from reducing the area, this helps with pre operative planning and gives patients a better understanding of the likely aesthetic outcome.
Understanding your treatment and outcome is important, along with the assistance confocal microscopy offers in ensuring this is effective.
Treating Lentigo Maligna
As a condition with fairly high risk of recurrence, removing lesions with a margin of healthy tissue is logical. With most lesions on the face, we do however consider an alternative.
Mohs surgery is an advanced technique designed to remove just the right amount of tissue to include cancerous cell but no more. “Slow Mohs” is a modified form, well suited to and recommended for Lentigo maligna treatment
The benefit slow Mohs offers have been highlighted at international dermatology conferences, as explained in this article. With a specialist Mohs team in house, the approach is available at our London clinics.
This spares normal tissue to the maximum degree, bringing cosmetic benefits by reducing repair of any resulting wound. In some cases a skin graft may be needed, although the likelihood is reduced, yet the cure rate is high.
There may be situations where surgery is not feasible. Radiotherapy, cryotherapy, or topical treatments are options, although as with any melanoma treatment, the surgical removal of lentigo maligna is preferred and sensible with the latest techniques.
Support At Skin Care Network
You can be certain our consultants will give your skin cancer treatment personal attention and advise on the best way forward. If you do need Lentigo maligna treatment in London, they can also arrange long term follow up, a wise precaution.
Good support staff and the latest diagnostic, or surgical equipment are further assets, although we believe the relationships we build with patients are the key to successful care.
If you have concerns about your skin, we would be pleased to hear from you and promise to treat you as the individual you are.