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Lentigo: causes, symptoms, diagnosis, treatment
Last reviewed: 08.07.2025
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Lentigo (syn.: solar lentigo, senile lentigo, liver spots) are small brownish spots that appear in people of any phototype due to excessive acute and chronic insolation.
Causes and pathogenesis of lentigo. They are a sign of acute and chronic photodamage (solar lentigo), an indirect sign of photoaging (senile lentigo). Less often induced by PUVA therapy (PUVA-induced lentigo). Insolation stimulates active melanin synthesis, as well as melanocyte proliferation. Perioral lentiginosis (Peutz-Jeghers syndrome) manifests itself in early childhood, it is often associated with polyposis of the stomach or intestine with a tendency to malignancy.
Symptoms of lentigo. Lentigo are small round, oval or irregular spots from light yellow to dark brown, localized on exposed areas of the skin (face, back of the hands, forearms, etc.). There is a tendency for peripheral growth. In some cases, the rash may be more widespread. Perioral lentiginosis is characterized by lentigo around the mouth, nose, on the red border of the lips and the mucous membrane of the lips, as well as in the area of the terminal phalanges of the fingers. The histological picture of lentigo includes an increase in the number of melanocytes at the border of the epidermis and dermis without signs of atypia and pigment incontinence. In PUVA-induced lentigo, which occurs in 2% of patients receiving PUVA therapy, atypia of melanocytes is detected.
Diagnosis of lentigo in most cases is not difficult and is based on anamnesis data and typical clinical manifestations.
Differential diagnosis is carried out with freckles, malignant lentigo, or Dubreuil's melanosis, and Recklinghausen's disease.
Treatment and prevention of lentigo. Active photoprotection is indicated, as well as external exfoliating and bleaching agents, LHE therapy. In case of PUVA-induced lentigo, PUVA therapy should be discontinued, and azelaic acid should be used externally. In case of oral lentiginosis, dispensary observation by a gastroenterologist is extremely important.
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