Report Increasing incidence of lentigo maligna and lentigo maligna melanoma in Catalonia Clara Matas-Nadal 1 , M.D , Josep Malvehy 2 , M.D., Ph.D, Jose Ramon Ferreres 3 , M.D, Aram Boada 4 , M.D, Domingo Bodet 5 , M.D, Sonia Segura 6 , M.D., Ph.D, Montse Salleras 7 , M.D, Antoni Azon 8 , M.D., Ph.D, Susana Bel-Pla 9 , M.D, Xavier Bigata 10 , M.D, Antoni Campoy 11 , M.D, Neus Curc  o 12 , M.D, Joan Dalmau 13 , M.D, Manel Formigon 14 , M.D., Ph.D, Alberto Gonzalez 15 , M.D, Miquel Just 16 , M.D., Ph.D, Enric Llistosella 17 , M.D, M. Elena Nogues 18 , M.D, Ramon Pedragosa 19 , M.D., Ph.D, Josep A. Pujol 20 , M.D, Mireia Sabat 21 , M.D, Joan A. Smandia 22 , M.D., Ph.D, Pedro Zaballos 23 , M.D., Ph.D, Susana Puig 2, *, M.D., Ph.D, and Rosa M. Mart  ı 1, *, M.D., Ph.D 1 Department of Dermatology, Hospital Universitari Arnau de Vilanova, University of Lleida, IRBLleida, Lleida & CIBERONC, Lleida, Spain, 2 Department of Dermatology, Hospital Cl  ınic de Barcelona (Melanoma Unit), University of Barcelona, IDIBAPS, Barcelona & CIBERER, Barcelona, Spain, 3 Department of Dermatology, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain, 4 Department of Dermatology, Universitari Germans Trias i Pujol, Badalona, Spain, 5 Department of Dermatology, Hospital Universitari Vall d’Hebron, Barcelona, Spain, 6 Department of Dermatology, Hospital del Mar, IMIM, Barcelona, Spain, 7 Department of Dermatology, Hospital Universitari Sagrat Cor, Barcelona, Spain, 8 Department of Dermatology, Hospital Universitari Sant Joan de Reus, Reus, Spain, 9 Department of Dermatology, Hospital Comarcal d’Amposta, Amposta, Spain, 10 Department of Dermatology, Hospital de Matar o, Matar o, Spain, 11 Department of Dermatology, Hospital General de Catalunya, Sant Cugat, Spain, 12 Department of Dermatology, Hospital Universitari M utua Terrassa, Terrassa, Spain, 13 Department of Dermatology, Hospital Santa Creu i Sant Pau, Barcelona, Spain, 14 Department of Dermatology, Consorci Sanitari de Terrassa, Terrassa, Spain, 15 Department of Dermatology, Consorci Sanitari Integral, L’Hospitalet de Llobregat, Spain, 16 Department of Dermatology, Hospital de Figueres, Figueres, Girona, Spain, 17 Department of Dermatology, Hospital Universitari Dr. Josep Trueta, Girona, Spain, 18 Department of Dermatology, Hospital d’Igualada, Igualada, Barcelona, Spain, 19 Department of Dermatology, Hospital Plato ´ , Barcelona, Spain, 20 Department of Dermatology, Hospital Universitari Joan XXIII, Tarragona, Spain, 21 Department of Dermatology, Hospital Parc Taulı ´, Sabadell, Spain, 22 Department of Dermatology, Hospital 2 de Maig, Barcelona, Spain, and 23 Department of Dermatology, Hospital de Santa Tecla, Tarragona, Spain Correspondence Clara Matas-Nadal, MD Department of Dermatology Hospital Universitari Arnau de Vilanova Avinguda Alcalde Rovira Roure 80 ES-25198 Lleida Spain E-mail: clamanadal@gmail.com *SP and RMM are co-senior authors. The authors declare no conflict of interest. Funding: Melanoma research at the Department of Dermatology of Hospital Universitari Arnau de Vilanova de Lleida is supported by grants from ISCIII (FIS-PI12/ 00260, FIS-PI15/00711 to RMM, cofinanced by FEDER “Una manera de hacer Europa” and CIBERONC- CB16/12/00231) and from Fundaci  o la Marat o de TV3 (FMTV 201331- 31 to RMM). The research at the Melanoma Unit in Barcelona is partially funded by Spanish Fondo de Investigaciones Sanitarias grants PI15/ 00716 and PI15/00956; CIBER de Enfermedades Raras of the Instituto de Salud Carlos III, Spain, cofinanced by European Development Regional Fund Abstract Background Recent epidemiological studies suggest that past data where superficial spreading melanoma was by far the most common subtype of melanoma may not reflect current patterns of sun exposure or other risk factors more involved in other subtypes of melanoma as lentigo maligna (LM) or lentigo maligna melanoma (LMM). Methods In order to measure the current situation in our country, all cases of LM and LMM diagnosed in 23 hospitals in Catalonia, from 2000 to 2007, were recorded. Results Although for the global period LM/LMM represented only 8.4% of cases, an increasing trend in this percentage was observed throughout the study period (from 6.9% [27 cases] in 2000 to 13.1% [94 cases] in 2007). Also, an increasing incidence of LM/LMM was observed, especially in chronically sun-exposed areas (85.5% involving the head and neck region). During the 8 years of the registry, the mean Breslow thickness of LMM remained stable. However, the increase in the number of LM (in situ) cases was significantly higher than the increase of the invasive ones. Conclusions An important observation from this data is that aging of population and current sun exposure patterns could keep increasing the incidence of LM/LMM, which may become an important public healthcare problem, over the other histological subtypes. In order to establish primary or secondary preventive measures to the LM/LMM risk- population, it is imperative to highlight the importance of chronic sun damage as a melanoma risk factor, and not only sunburn, most commonly addressed in melanoma prevention campaigns. ª 2018 The International Society of Dermatology International Journal of Dermatology 2018 1