Brown Patch on Face – Innocent or Suspicious?
Welcome to what I intend to become a weekly series of dermatology pictures, start with a brown patch on face, aimed at raising awareness of skin lesions or problems that need investigating, as well as educating on some of the more common blemishes that are in fact innocent.
So, this Brown Patch on Face – is it Innocent or Suspicious?
This lesion is not innocent, it is in fact suspicious.
This is a Lentigo Maligna, which is a type of skin cancer called melanoma, at its earliest stages. It is definitely important to have this investigated and treated. It is also important to have this done early, because if this is allowed to develop it can become far more difficult to treat. For instance, at this stage it is likely to require a relatively simple procedure here in Grand Cayman, whereas if left, its development may require more major surgery and treatment including an extended visit to somewhere like Miami.
We also cannot forget that melanoma is a skin cancer that leads to many deaths each year (more than 2 people die of skin cancer in the U.S. every hour), and yet when treated early, it has extremely good outcomes.
How do we diagnose Lentigo Maligna?
You are in fact the first line of identification. Lentigo Maligna appears typically in sun-exposed areas, for example as a brown patch on the face, with a iregular outline, and then slowly enlarges and becomes darker or develops darker areas. It is what we call an ‘in situ’ melanoma, meaning it is localise to the external layers of the skin, but has the potential to spread. Consequently, it tends to be asymptomatic, and so it is important therefore that if you spot something like this, you seek professional advice from your dermatologist in Cayman.
When presented to me, a specialist in detection of skin cancers, I examine the skin carefully using a magnifying device called a Dermatoscope. This allows me to look at the lesion under very high magnification. I would typically also encourage you to undergo mole mapping using our state-of-the-art FotoFinder mole mapping system, which is supported by artificial intelligence. Between the dermatologist and the device, backed up by AI, we are able to very accurately determine what a lesion may or may not be.
How is it treated?
The commonest form of treatment for Lentigo Maligna is minor surgery. When identified early, generally the lesion can be completely removed and no further treatments are required. However, as we now know you are somewhat predisposed to these types of lesions, we would then want to set a sensible schedule of repeat mole mapping, which has the advantage that our advanced scanner will also be able to tell which are new moles and which are moles that have changed in size, shape or colour.
