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Skin-Melanocytic tumors
Solar lentigo
Author: Nat Pernick, M.D., PathologyOutlines.com, Inc.
Revised: 26 October 2009, last major update June 2009
Definition
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● Benign melanocytic proliferation due to sun exposure (Br J Dermatol 2007;156:1214)
● Multiple lesions, often poorly circumscribed
Terminology
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● Also called solar lentigines, age spots
Epidemiology
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● Sun exposed skin of elderly (90% of whites age 60+); also truck drivers on sun-exposed face (J Dermatol 2008;35:146)
● Multiple large solar lentigos on the upper back and shoulders suggest prior severe sunburn, a risk factor for melanoma (Dermatology 2007;214:25)
Treatment and prognosis
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● Laser (J Am Acad Dermatol 2006;54:S262)
● Intense pulsed light (Dermatol Surg 2007;33:449)
● Cryotherapy
● Trichloroacetic acid (J Eur Acad Dermatol Venereol 2008;22:316)
Clinical description
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● Macular hyperpigmentation
● Often > 1 cm
Clinical images
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Back lesions Pre- and post-laser treatment
Dermoscopy
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● Sharply demarcated border and fingerprint like structures
Dermoscopy images
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Various images
Micro description
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● Elongation of rete ridges and increased pigmentation at the tips of the retes; pigmentation may be irregular
● Also elastosis, telangiectasia, variable chronic inflammatory infiltrate in dermis
● May have transepidermal elimination of melanin pigment
Differential Diagnoses
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● Lentigo maligna - clusters of MelanA+ cells at dermoepidermal junction, versus scattered for solar lentigo (J Cutan Pathol 2008;35:931)
● Actinic keratosis
Additional references
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End of Skin-Melanocytic Tumors > Solar lentigo
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