Differential Diagnosis of Actinic Keratosis vs Lentigo Maligna

A 77-yr-old man was evaluated by his dermatologist and found to have a macular, irregular hyperpigmented patch on his face. He had extensive sun damage and a history of many previous actinic keratoses and basal cell carcinomas. The clinical differential diagnosis included pigmented actinic keratosis, solar lentigo and lentigo maligna type of melanoma in situ. Biopsies were performed and are depicted in Fig. 7.

Table 4

Differential Diagnosis of Actinic Keratosis and Lentigo Maligna

Table 4

Differential Diagnosis of Actinic Keratosis and Lentigo Maligna

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