Solar Lentigo
Ilaria Ghersetich, Benedetta Brazzini, Maria Pia De Padova, Antonella Tosti
The author has no financial interest in any of the products or equipment mentioned in this chapter.
18
Contents
18.1 Definition . . . . 199
18.2 Epidemiology . . . . 199
18.3 Etiology . . . . 199
18.4 Clinical Features . . . . 199
18.5 Pathology . . . . 200
18.6 Diagnostic Criteria . . . . 200
18.7 Therapy . . . . 200
References . . . . 205
18.1 Definition
Solar lentigo are a macular area of brown pig- mentation appearing after either acute or chronic sun exposure. The term solar lentigo is preferred to senile lentigo, which is sometimes
used to describe early lentigo maligna, pig- mented actinic keratoses and the flat type of seborrhoeic keratoses [1].
18.2 Epidemiology
Lentigo are so common that it is difficult to make an exact statement about their epidemi- ology.
18.3 Etiology
Photo-aging is the cause of solar lentigo.
18.4 Clinical Features
In younger patients solar lentigo are seen on sun-exposed areas (Fig. 18.1). There is usually a
Fig. 18.1.
In younger patients solar lentigo are seen on sun-exposed areas
history of acute sunburn followed by the sud- den appearance of large numbers of these mac- ular lesions.
In older patients these lesions are commonly seen on the face and back of the hands after chronic sun exposure (Figs. 18.2) [1].
18
Fig. 18.2.
Solar lentigo after chronic sun exposure
18.5 Pathology
쐽 Linear increase of melanocytes at the dermoepidermal junction 쐽 No cytological atypia
쐽 Possible elongation of the papillae and interpapillary ridges [2]
18.6 Diagnostic Criteria
쐽 Histopathology 쐽 Dermatoscopy
18.7 Therapy
쐽 Sunscreens
쐽 Topical depigmenting agents (tirosinase inhibitors, antioxidants, peeling agents, melanogenesis inhibitors) [3]
쐽 Chemical peelings (trichloroacetic acid) (Figs. 18.3, 18.4, 18.5 and 18.6) [4]
쐽 Criotherapy [5]
쐽 Laser [6]
Fig. 18.3a, b.
Solar lentigo treated with 25% TCA
a
b
18 Fig. 18.4a–c.Solar lentigo at baseline (a), during peeling with 25% TCA (b) and after 30 days (c). Note in c the presence of an inflammatory halo that could persist for 2–3 months
a b
c
Fig. 18.5a, b.
Solar lentigo of the forehead treated with
TCA 25% a
a
18
Fig. 18.6a, b.
Solar lentigo of the hands treated with 25% TCA.
bSolar lentigo after 4 days of peeling, dryness and hyper- pigmentation
a
b
References
1. Kim NY, Pandya AG (1998) Pigmentary diseases.
Med Clin North Am 82 : 1185–1207
2. Pierard GE, Pierard-Franchimont C, Laso Dosal F et al (1991) Pigmentary changes in skin senescence.
J Appl Cosmetol 9 : 63–67
3. Dooley TP (1997) Topical skin depigmentation agents: current products and discovery of novel inhibitor of melanogenesis. J Dermatol Treat 8 : 275–279
4. Ghersetich I, Brazzini B, Lotti T (2003) Chemical peeling. In: Katsambas AD, Lotti TM (eds) European handbook of dermatological treatments, 2nd ed.
Springer, Berlin, Heidelberg, New York, pp 599–612 5. Zouboulis CC, Rosenberger AD, Adler Y, Orfanos CE
(1999) Treatment of solar lentigo with cryosurgery.
Acta Derm Venereol 79(6) : 489–490
6. Chan HH, Kono T (2004) The use of lasers and intense pulsed light sources for the treatment of pig- mentary lesions. Skin Therapy Lett 9(8) : 5–7 Fig. 18.6c, d.
Solar lentigo 1 month after 25% TCA peel
c
d
Management of the Patient IV
