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Simple Lentigo

Simple lentigos are very common, particularly in those with red hair and fair skin. They usually appear during childhood and increase in number until the age of 40. The majority of lentigines remain unchanged in adult life.

Lentigines are hyperpigmented macules that do not fade away in the absence of UV exposure. Lentigines are poorly circumscribed, uniformly pigmented macules, with a round or oval shape and a diameter of up to 5 mm. There may be slight scaling of the surface, and several neighbouring lesions may coalesce. Their colour is pale to deep brown, depending on the skin colour of the individual. They are primarily located on photo‐exposed areas as they are part of the spectrum of lesions (ephelides, simple lentigos, solar lentigos) resulting from excessive UV exposure.

The differential diagnosis of lentigines from freckles is made clinically by their comparatively darker colour, more scattered distribution and by their unchanged status in relation to sunlight exposure. In contrast to freckles, lentigines present histologically with an increased number of melanocytes

Management

As the majority arise in sun‐exposed areas, photoprotection could decrease the rate of new lesions developing. For cosmetic reasons, a variety of depigmenting topical agents and dermatological procedures such as chemical peels, lasers and photodynamic therapy reduces their pigmentation. In patients with multiple lentigines arising early in life on non‐sun‐exposed sites, the possibility of a hereditary multisystem syndrome should be considered. In the very rare cases of generalized lentiginoses, individuals may be at increased risk for melanoma, and thus should be educated on avoidance of sunburn and self skin examination.

Sun Spots/Age Spots/solar lentigo:

sun spotsA solar lentigo is a brown macule appearing after excessive sun exposure. The number of solar lentigines keep increasing with age. Solar lentigines are associated with both intermittent and chronic sun exposure. Solar lentigines on the back have also been associated with a history of sunburns before the age of 20 years, while facial solar lentigines have been associated with cutaneous signs of photodamage.

in younger patients, solar lentigines are most commonly seen on sun‐exposed sites, such as the face in both sexes and the shoulders in males. They are macular, tan coloured and may be very large, with a striking irregular border. There is frequently a history of acute sunburn, followed by the sudden appearance of large numbers of these irregular macular lesions

Solar lentigines are also seen on older, fair‐skinned patients who have had excessive sun exposure. The backs of the hands and the face are common sites. Once again the lesions are large and macular, have an irregular edge and are usually a uniform shade of brown.

Management

Patients often request treatment for these pigmented lesions located in visible body areas such as the face and back of hands.

Rigorous photoprotection with sun avoidance, use of a broad spectrum and high sun‐protection‐factor sunscreen, and appropriate clothing lowers the possibility of further lesions emerging in the future, and may also result in some degree of spontaneous resolution.

Orion Aesthetics uses Q Switched Nd:YAG to selectively destroy the excess melanin pigment in the epidermis.