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Lentigo simplex in Adult
Other Resources UpToDate PubMed

Lentigo simplex in Adult

Contributors: William M. Lin MD, Susan Burgin MD, Lowell A. Goldsmith MD, MPH
Other Resources UpToDate PubMed

Synopsis

Lentigo simplex is a common benign, hyperpigmented macule located anywhere on the body. These lentigines generally occur early in life and are not associated with sun exposure. They result from a mild increase in the number of normal melanocytes in the epidermis producing increased amounts of melanin.

Clinically, asymptomatic, well-circumscribed, symmetric, homogeneous, light brown to black macules are seen. They are usually smaller than 5 mm in size. They are distributed anywhere on the trunk, extremities, genitals, and mucous membranes. Lentigines found on mucous membranes can appear irregular with increased size, irregular borders, and heterogeneous pigmentation. Lentigo simplex may evolve into junctional nevi but are not thought to evolve into melanoma. They differ from solar lentigines in that they appear earlier in life on non-sun-exposed skin. They occasionally form in cutaneous scars and may be associated with psoralen / ultraviolet light therapy.

Lentigo simplex may occur as a single or as multiple lesions. Occasionally, multiple lentigines are associated with rare genetic disorders. These include the following:
  • LEOPARD syndrome – lentigines, ECG changes, ocular hypertelorism, pulmonary stenosis, abnormal genitalia, growth retardation, and deafness
  • Carney complex – lentigines, atrial myxoma, mucocutaneous myxoma, and nevi
  • Peutz-Jeghers syndrome – lentigines (perioral and oral), multiple gastrointestinal polyps, and visceral tumors (pancreas, ovary, testes)
  • Xeroderma pigmentosum – lentigines on sun-exposed skin and multiple skin cancers
  • Cronkhite-Canada syndrome – lentigines (buccal mucosa, face, palmoplantar), alopecia, nail dystrophy, and intestinal polyps
Other rare disorders associated with multiple lentigines include generalized lentigines, arterial dissection with lentiginosis, Laugier-Hunziker syndrome, Cantú (hyperkeratosis-hyperpigmentation) syndrome, Cowden disease, centrofacial lentiginosis, and Bannayan-Riley-Ruvalcaba syndrome.

Codes

ICD10CM:
L81.4 – Other melanin hyperpigmentation

SNOMEDCT:
398900000 – Lentigo simplex

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

  • Inherited patterned lentiginosis – Individuals of African descent frequently have centrofacial lentigines that are autosomal-dominantly inherited.
  • A Solar lentigo typically occurs on sun-exposed surfaces with increasing age and may be less regular in appearance.
  • Common acquired nevus
  • Atypical nevus
  • Pigmented Actinic keratosis
  • Café au lait spot is macular, often larger, and present from the time of infancy.
  • Lentigo maligna
  • Melanoma
  • Ephelides
  • Seborrheic keratosis
Oral:
  • Oral melanotic macule
  • Amalgam tattoo
  • Mucosal Melanoma

Best Tests

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Management Pearls

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Therapy

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References

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Last Updated:08/25/2021
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Patient Information for Lentigo simplex in Adult
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Lentigo simplex in Adult
A medical illustration showing key findings of Lentigo simplex : Black color, Brown color, Hyperpigmented macule
Clinical image of Lentigo simplex - imageId=3435273. Click to open in gallery.  caption: 'A close-up of two well-demarcated brown macules.'
A close-up of two well-demarcated brown macules.
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