Which physical findings are characteristic of solar lentigo?

Updated: Feb 23, 2021
  • Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD  more...
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Answer

Solar lentigo (eg, actinic lentigo, senile lentigo, sun spot, liver spot) is the most common benign sun-induced lesion that occurs in sun-exposed areas. Solar lentigo most commonly appears on the face, arms, dorsa of the hands, and upper part of the trunk. The spots initially are smaller than 5 mm in diameter. The surface of the lesions is either flat or depressed, and it may be split by fine wrinkles.

The lesions are usually brown, but the color may range from yellow-tan to black. Older lesions are often dark brown or brownish black. Solar lentigines slowly increase in number and in size. Many lesions eventually coalesce to form larger patches. Although these lesions are most common in individuals aged 30-50 years, they are now seen in younger individuals because of their increased exposure to sun tanning and the use of artificial sources of UV light. Although they are often called liver spots, they are not a manifestation of systemic disease.

In vivo reflectance confocal microscopy may show solar lentigines having increased melanin and hemoglobin levels and a higher rate of epidermal proliferation. Deformation and the number of the hyperrefractive dermal papillary rings may increase significantly over the 5-year time span, with the lentigo size enhanced and color darkened. [20, 21]


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