solar (senile) lentigo
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Etiology
- localized proliferation of melanocytes due to chronic exposure to sunlight
- predisposition in fair skinned individuals
Epidemiology
- generally > 40 years of age
- no sex preference
- most common in Caucasians
Pathology
- elongated rete ridges with increased melanocytes & hypermelanosis in the basal layer
Clinical manifestations
- 1-3 cm brown macules, but may be up to 5 cm
- light to dark brown. may be variegated
- slightly irregular border
- multiple scattered discrete lesions
- lesions occur on sun-exposed areas
- generally on extremities rather than trunk
* images[3]
Differential diagnosis
- seborrheic keratosis: (macules evolve into verrucous papules & plaques with 'stuck on' appearance. often on trunk)
- pigmented actinic keratosis
- lentigo maligna
- solar lentigines > 1 cm in diameter or irregularly shaped[2]
Management
- skin biopsy if malignancy suspected
- cryotherapy, quality-switched laser therapy, or intense pulsed light if malignancy not a concern[4]
More general terms
Additional terms
References
- ↑ Color Atlas & Synopsis of Clinical Dermatology, Common & Serious Diseases, 3rd ed, Fitzpatrick et al, McGraw Hill, NY, 1997, pg 236
- ↑ 2.0 2.1 Medical Knowledge Self Assessment Program (MKSAP) 16, 19. American College of Physicians, Philadelphia 2012, 2021.
- ↑ 3.0 3.1 DermNet NZ. Brown spots and freckles (images) http://www.dermnetnz.org/lesions/freckles.html
- ↑ 4.0 4.1 Plensdorf S, Livieratos M, Dada N. Pigmentation Disorders: Diagnosis and Management. Am Fam Physician. 2017 Dec 15;96(12):797-804. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29431372 Free article. Review.