What should you know about dermoscopy of lentigo maligna?

Lentigo maligna can appear as a slowly changing flat pigmented patch, often on chronically sun-exposed skin. Through a dermatoscope, the clinician evaluates the arrangement of colour, the border, follicle-related pigment, and whether different areas look unlike one another. A pattern may raise concern, but dermoscopy cannot by itself establish the diagnosis or show the full depth of a lesion. Freckles, sun spots, and other benign marks can overlap visually. The examination helps the dermatologist select the safest next step and the area most useful to sample if a biopsy is advised.

Seek a dermatology appointment for a new, enlarging, darkening, or irregular patch on the face, scalp, ears, or another sun-exposed site. Bring photographs that show how it has changed and mention previous procedures, sun exposure, and products used on the area. Do not try to lighten, peel, freeze, or remove the patch at home. Depending on the examination, the clinician may photograph it, arrange a biopsy, or discuss removal after diagnosis. Protect the area from further sun exposure while waiting for review.

Arrange prompt assessment if the patch changes noticeably, develops a new uneven edge, bleeds, crusts, becomes sore, or extends into nearby skin. A flat lesion can still deserve attention even when it does not hurt. These warning features do not prove lentigo maligna, but delaying assessment can make it harder to compare the original pattern. Ask for an earlier review if the lesion is changing while you wait for a routine appointment.

Ask what dermoscopic features prompted concern, whether a biopsy is recommended, and how the sampling site will be selected. Ask about wound care, expected healing, when results will be discussed, and how future sun-exposed skin checks should be planned.