Lentigo maligna melanoma (LMM) is a subtype of melanoma, which is a type of skin cancer that can be dangerous and starts from melanocytes, the skin's pigment-producing cells. Protheragen provides a variety of solutions related to the development of diagnostic and therapeutic agents for Lentigo Maligna Melanoma (LMM).
Overview of Lentigo Maligna Melanoma (LMM)
Lentigo maligna melanoma (LMM) develops from the LM (lentigo maligna), which is classified as an in situ melanoma. LM is distinguished by the presence of atypical melanocytes that invade the basal layer of the epidermis in sun-damaged skin. LMM is most commonly found in the elderly, especially in the age group of 65-80 years. Its most common location is the head and neck, although sometimes it can also be found on the trunk and extremities. LM can advance to LMM if not treated, and becomes an invasive melanoma which poses the same risks as other invasive melanomas. LM and LMM are diagnosed (and confirmed) by histopathological and biopsy examination in conjunction with the clinical and dermoscopic findings. Early signs of LM are the repigmentation of previously white or gray hair and a tan-brown macule or patch with edges that are not smooth and multi-colored.
Fig.1 Progression model of lentigo maligna (LM)/lentigo maligna melanoma (LMM) progression with dermoscopy and confocal microscopy. (Guida S.,
et al., 2023)
Diagnostics Development for Lentigo Maligna Melanoma (LMM)
- Reflectance Confocal Microscopy (RCM)
Reflectance confocal microscopy (RCM) is a type of imaging technology which is non-invasive and uses an imaging technique of RCM to create near-infrared laser light images yielding quasi-histological images. RCM has the capability to detect small amounts of melanin, which are imperceptible to the dermascope. RCM is an essential tool in recognizing the amelanotic/hypomelanotic lesions and LMM lesions, which recur on the neck and face.
- Dermoscopy
Dermoscopy utilizes polarized or non-polarized light sources with handheld magnifying glasses, which are usually 10x, to sharpen light and enhance the detailed visualization of skin structures. For both pigmented and non-pigmented lesions, this improvement in visualization allows dermoscopy to sharpen diagnostic accuracy. Moreover, dermoscopy has been proven to be more effective than Wood's lamp inspection in distinguishing the borders of LMM. It is critical to note that the skin on the face is populated with numerous fine hair follicles, attenuated rete ridges, and openings of sweat glands, which, during the assessment of facial LMM, can form a pseudonetwork.
- Wood's Lamp
A Wood's lamp is effective for diagnosis and can be used for the detection of subclinical lesions of actinic keratosis after 5-aminolevulinic acid (ALA) therapy. Also, it can be utilized for evaluating surgical margins in LMM. However, the utility of the Wood's lamp is restricted owing to the numerous activated melanocytes in photodamaged skin, which can result in misdiagnoses.
Therapeutics Development for Lentigo Maligna Melanoma (LMM)
Examples of non-surgical therapies are cryotherapy, laser therapy, radiation therapy, and topical therapies like imiquimod. The recurrence rate of cryotherapy ranges from 0 to 40%, whereas different lasers have a recurrence rate from 0 to 37.8%. Radiation therapy has good short-term cosmetic results and is suitable for patients who cannot undergo surgery. Topical imiquimod has been used in place of surgery, and some reports have documented considerable histologic clearance. Regardless, these non-surgical options lack uniformity in effectiveness, and patients need to be kept under close observation for lack of response.
Table 1. Therapeutics of Lentigo Maligna Melanoma (LMM).
| Therapeutics |
Drug Name |
Mechanism |
Description |
Stage |
| Topical Therapy |
Imiquimod |
Immune modulation |
A topical cream that stimulates the immune system to attack melanoma cells. |
Approved |
| Topical Therapy |
Tazarotene |
Retinoid action |
Topical retinoid that may enhance the effects of imiquimod or be used alone. |
Approved |
| Laser Therapy |
- |
Photothermal ablation |
Use of laser energy to destroy melanoma cells. |
Approved |
Disclaimer: Protheragen focuses on providing preclinical research services. This table is for information exchange purposes only. This table is not a treatment plan recommendation. For guidance on treatment options, please visit a regular hospital.
Our Services
Protheragen's expert team is at the forefront of advancing LMM diagnostics and therapeutics through comprehensive preclinical research and development. By employing cutting-edge imaging technologies and assessing innovative therapeutic options, our services are meticulously tailored to address the specific needs of each project. With a steadfast commitment to scientific excellence and continuous innovation, we ensure that our clients receive the highest level of support for their LMM research and development initiatives.
Disease Models
- 3D Spheroid Models
- Ultraviolet (UV) Induction Model
- Cdk4::NRAS Mouse Models
- Chick Embryo Melanoma Models
- Spontaneous Canine Melanoma
Protheragen's preclinical research services for LMM are crafted to accelerate the development of innovative diagnostics and therapeutics. Our offerings include the application of advanced imaging techniques to enhance diagnostic precision, as well as the thorough evaluation of cutting-edge therapeutic solutions. If you are interested in our services, please feel free to contact us.
References
- Guida, Stefania, et al. "Lentigo maligna and lentigo maligna melanoma in vivo differentiation with dermoscopy and reflectance confocal microscopy: A retrospective, multicentre study." Journal of the European Academy of Dermatology and Venereology 37.11 (2023): 2293-2300.
- Naik, Piyu Parth. "Diagnosis and management of lentigo maligna: clinical presentation and comprehensive review." Journal of Skin Cancer 2021.1 (2021): 7178305.
- Vaienti, Silvia, Paolo Calzari, and Gianluca Nazzaro. "Topical treatment of melanoma in situ, lentigo maligna, and lentigo maligna melanoma with imiquimod cream: a systematic review of the literature." Dermatology and therapy 13.10 (2023): 2187-2215.
All of our services and products are intended for preclinical research use only and cannot be used to diagnose, treat or manage patients.
