Nevoidal lentigo L81.4

Flat, mostly <0.5 cm large, brownish or brown-black spot which is pathogenetically interpreted as a transitional position from lentigo simplex to a melanocytic nevus of the junctional type.

Clinically, these small spatter-like pigment nevi are often confused with an initial malignant melanoma (or are clinically not definable). The characteristic reticular structures of the benign melanocytic nevus are often absent under the reflected light microscope due to a broad discharge of pigment (histologically: pigmented parakeratosis) into the stratum corneum. It is helpful to tear off the stratum corneum's tesa film, which makes the network visible.

Histological profile (var. n. Cerroni et al.):

• Small symmetrical sharply defined lesion
• Pronounced pigmentation of the epidermis with elongated retelions
• Melanin in the stratum corneum (pigmented parakeratosis)
• Melanocytes in single formations and small nests at the dermo-epidermal junction zone
• Melanophages in the statum papillare

There is reasonable doubt about the necessity to define the (histological) term "naevoid lentigo" as a clinical entity. Ultimately, it is a highly pigmented variant of a common acquired melanocytic nevus. It is dispensable.

1. Cerroni L et al (2016) Histopathology of the skin. 2nd edition. Springer-Verlag GmbH Heidelberg, Berlin S 614