Lentigo (syn: solar lentigo, senile lentigo, hepatic spots) - small brownish spots that occur in individuals of any phototype against the background of 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 are induced by PUVA therapy (PUVA-induced lentigo). Insolation stimulates the active synthesis of melanin, as well as the proliferation of melanocytes. Periodic lentiginosis (Peits-Jigers syndrome) is manifested in early childhood, it is often associated with polyposis of the stomach or intestines with a tendency to malignancy.
Symptoms of lentigo. Lentigos are small spots of round, oval or irregular shape from light yellow to dark brown, localized in the open areas of the skin (face, back surface of hands, forearms, etc.). There is a tendency toward peripheral growth. In some cases, rashes may be more common. With perioral lentiginosis, lentigo is characteristic around the mouth, nose, on the red border of the lips and the mucous membrane of the lips, and also in the region of the terminal phalanges of the fingers of the hands. The histological picture of lentigo includes an increase in the number of melanocytes on the border of the epidermis and the dermis without signs of atypism and incontinence of the pigment. In PUVA-induced lentigo, occurring in 2% of patients receiving PUVA therapy, melanocyte atypism is detected.
Diagnosis of lentigo in most cases is not difficult and is based on history data, typical clinical manifestations.
Differential diagnosis is carried out with freckles, malignant lentigo, or melanosis of Duble, Recklinghausen's disease.
Treatment and prevention of lentigo. Active photoprotection is shown, as well as external exfoliating and bleaching agents, LHE-therapy. When PUVA-induced lentigo shows a rejection of PUVA therapy, external - azelaic acid. When oral lentiginosis is extremely important dispensary observation in the gastroenterologist.
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