Cryosurgical treatment of lentigo maligna

BACKGROUND: Lentigo maligna (LM) is a common melanocytic malignancy which requires therapy because of the risk of progression to invasive lentigo maligna melanoma which a much worse prognosis. PATIENTS AND METHODS: 18 patients with clinical and histopathological diagnosis of LM were treated with cryosurgery. The patients were older Caucasians (mean age 59.5 years) and 11 were male. They were chosen for cryosurgery because the lesion posed a surgical challenge or the patient was not a good surgical candidate. They were treated with two freeze-thaw cycles of liquid nitrogen under local anesthesia in a single sitting. Lesions larger than 2 cm(2) were divided into smaller segments for freezing. RESULTS: The lesions resolved clinically in all cases, with no recurrence or metastasis detected during a mean follow-up of 75.5 months. Some patients developed hypopigmented scars. CONCLUSIONS: Cryosurgery with liquid nitrogen is an efficient, safe and in most cases aesthetically acceptable alternative method to treat LM.