Early diagnosis of lentigo maligna (LM) represents one of the most challenging tasks in dermato-oncology. This is because pigmented actinic keratosis (pAK), solar lentigo (SL), seborrheic keratosis (SK), and lichen planus-like keratosis (LPLK) share several phenotypic features with melanoma in situ both macroscopically and on dermoscopic examination.