Lentigo simplex L81.42

Author: Prof. Dr. med. Peter Altmeyer

Last updated on: 06.04.2023

Synonym(s)

Ink spot lentigo; juvenile lentigo; Lens mark; lentigo benigna; reticular lentigo

Definition
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Not uniformly defined and used (clinical and histological) term for a usually 0.1-0.3 cm large, but also larger (up to 3.0 cm), acquired (e.g. due to actinic influences = lentigo solaris = lentigo senilis), seasonally non-reversible, brown pigment spot of the skin and/or mucosa (lentigo of the mucosa/melanoticspots of the mucosa), caused by a linear proliferation of basal melanocytes.

A lentigo simplex may progress to a junctional nevus (see nevus melanocytärer below ) or to a seborrheic keratosis.

Congenital lentigo is not referred to as such, but as a nevus spilus or café-au-lait spot.

The "freckles" seen in fair-skinned young children in the summer months are not called lentigines, but ephelides. Unlike lentigines, they completely regress during the winter months.

In the case of circumscribed mucosal pigmentation(melanotic patches of the mucous membranes - mucosal lentigo), the terms "lentigo" and " melanosis" are often used synonymously.

Etiopathogenesis
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Lentigo simplex is in most cases the early form of an acquired melanocytic nevus, which develops (according to a genetic program) over years in phases from lentigo simplex to a nevoid lentigo, from the melanocytic nevus of the juvenile nevus to the melanocytic nevus of the dermal type. This phased process is not always inevitable. Thus Lentigines UV-induced are formed at any age. The later they are formed, the less frequently they develop into the classic melanocytic nevus. In red-haired individuals ( sensitivity type I) this phased development to a melanocytic nevus usually does not take place, so that this skin type has many lentigines, but few melanocytic nevi. Also the patient with peripheral neurofibromatosis very rarely realizes melanocytic nevi. The skin and mucosal lentiginosis in Peutz-Jeghers syndrome should be subjected to an equally differentiated evaluation, since this is an endogenously induced lentiginosis.

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Manifestation
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Often occurring as early as infancy. Lentigo simplex can manifest itself at any age.

Clinical features
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Integument: Mostly occurring in plural, pinhead- to lentil-sized, brown, sharply defined hyperpigmentations. Preference for light-exposed areas of skin. A transition into a melanocytic nevus is possible.
Reflected light microscopy: Regular, prominent pigment network, possibly central diffuse pigmentation, thinning of the pigment network in the periphery.

S.a.u. naevoid lentigo; see below lentiginosis.

Histology
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Usually normally configured epithelial ligament, but also irregular, often club-shaped extension of the reteleasts (transitions to Verruca seborrhoica are usually fluid). Pronounced basal hyperpigmentation. Minor melanocytic hyperplasia is also possible. Ample melanophages are found in the upper dermis.