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Lentigo simplex in Adult
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Lentigo simplex in Adult

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Contributors: William M. Lin MD, Susan Burgin MD, Lowell A. Goldsmith MD, MPH
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Synopsis

Lentigo simplex : Black color, Brown color, Hyperpigmented macule
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

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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 : Black color, Brown color, Hyperpigmented macule

Overview

Lentigo simplex is a type of color-containing (pigmented) lesion not caused by sun exposure, which looks like the freckle-like condition (lentigo) caused by sun exposure (solar lentigo). In both conditions, an increased number of pigment-producing cells (melanocytes) are present. Lentigo simplex can occur anywhere on the body, including areas that are not exposed to sunlight. Multiple lentigos are associated with several inherited syndromes, but lentigo simplex can also occur as a single lesion. Single lesions often develop on the lips or on the gums. Lesions may be caused by some forms of ultraviolet light therapy. If this is the case, the lesion may be seen as identical to those caused by exposure to sunlight.

Who’s At Risk

Lentigo simplex may occur in people of all ages. The lesions usually appear first in early childhood, but they can also be present at birth or develop later in life.

Signs & Symptoms

Lentigo simplex can occur anywhere on the body, including areas that are not exposed to sunlight. They appear as brown to almost black, small spots (macules), usually 3 mm or smaller in diameter. The edges (margins) may be smooth or somewhat jagged with even distribution of color.

Self-Care Guidelines

None necessary.

When to Seek Medical Care

See a physician for evaluation of any colored (pigmented) lesion if you are not sure what it is.

Treatments

Lentigo simplex is a non-cancerous (benign) lesion. Your physician may recommend:
  • Periodic follow-up evaluations.
  • Surgical removal of single lesions that may be difficult to distinguish from malignant lesions, such as melanomas.

References


Bolognia, Jean L., ed. Dermatology, pp.981, 1761-1763. New York: Mosby, 2003.

Freedberg, Irwin M., ed. Fitzpatrick's Dermatology in General Medicine. 6th ed, pp.863, 882-884. New York: McGraw-Hill, 2003.
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Lentigo simplex in Adult
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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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