AGGRESSIVE AMELANOTIC LENTIGO MALIGNA

A 66-year-old woman had a long-standing, scaly erythematous lesion on her left temple which histologically showed features of amelanotic len tigo maligna. It had recurred on numerous occasions over a period of 1 7 years, in spite of multiple attempts at curative surgery. There were also recurrences within a skin graft which, to our knowledge, has not been documented previously with lentigo maligna. In spite of the prol onged course, and extensive intraepidermal melanocytic proliferation a mounting to melanoma in situ, there has been no evidence of dermal inv asion. The lack of pigmentation in such lesions means that clinical de finition of margins is highly inaccurate. In view of the aggressive ho rizontal growth phase of this lesion, with rapid recurrence following surgery, it was treated with electron beam therapy, and this has resul ted in complete clinical remission. This most unusual case illustrates the potential difficulties in diagnosis and management of amelanotic lentigo maligna.