AMELANOTIC LENTIGO-MALIGNA MELANOMA - A DIAGNOSTIC CONUNDRUM-PRESENTATION OF 4 NEW CASES

BACKGROUND. The clinical appearance of amelanotic lentigo maligna mela noma (ALMM) is quite confusing and usually is not diagnosed prior to h istopathologic examination. METHODS. We have studied four new patients with ALMM whose correct diagnosis was not obtained from any one clini cal finding, We arrived at the final diagnosis in an unexpected way, h aving had biopsied the lesions for diagnoses other than malignant mela noma. RESULTS. ALMM presents as a nonspecific skin lesion with no sing le indicative characteristic. A search of the literature confirmed our difficulty in making the diagnosis. CONCLUSIONS. To diagnose ALMM, on e has to be cognizant of this condition and has to consider a constell ation of findings that are unusual with melanocytic lesions. Questiona ble lesions must be biopsied for definitive histopathologic diagnosis. (C) 1996 American Cancer Society.