By Gary M. White, MD
The solar lentigo (plural lentigines) is a small, pigmented flat or slightly raise is a brown macule or patch that is induced by sun exposure.
Both solar lentigines and freckles are pigmented macules occurring in response to sun exposure. However, significant differences exist. Solar lentigines are larger in size but fewer in number compared to freckles. Solar lentigines increase in number with age whereas freckles decrease. Freckles occur in fair-skinned and red-haired individuals whereas solar lentigines occur in all races.
A relatively uniformly-colored tan or brown macule or patch is seen on the sun-exposed areas of the skin. It is most common on the cheeks and back of the hands.
Any pigmented lesion should be evaluated for the ABCD's and biopsied if indicated. If the lesion appears benign, no treatment is needed. Several therapies may be tried for cosmesis. Cryotherapy is safe and simple although hypopigmentation is a common sequelae and may be persistent for 6 months or more. Local dermabrasion is also effective and less likely to cause hypopigmentation. Topical tretinoin (e.g. Renova) can lighten lentigines over 6-12 months. The Q-switched Nd:YAG laser may help [J Cosmet Laser Ther. 2014;16:83-8].
Note the sharp demarcation at the waist.
Two solar lentigines in a background of sun damage.
Melasma and a solar lentigo.
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