Ink spot lentigo

2071

Also known as reticulated black solar lentigo.

A variant of solar lentigo.

Characterized by very dark color with a beaded or wiry irregular outline.

More common in fair skinned people.

Peak age of diagnosis is between 30-40 years.

More common in males.

More common in sun-exposed areas on solar damaged skin.

More common in patients with fair skin and history of sunburns.

Histologicallh features include lentiginous hyperplasia of the epidermis, melanocytes mainly around the rete ridges, skip areas lacking pigment that involve the supra papillary epidermis, and rete ridges.

Usually presents as a solitary, reticulated black macula with a wiry or beaded, markedly irregular, reminiscent of a spot of black ink on the skin.

Lesion size is often less than 5 mm.

Trunk most common site.

Usually associated with solar-induced freklles, solar lentigines, and actinic keratoses in the surrounding areas.
Diagnosis is clinical.

Dermis copy is helpful for diagnosis, with mono morphic, reticulated pattern with beaded or spider-like wiry outline.

Skin biopsy occasionally neede for diagnosis.

Must be differentiated from a melanoma.

A relatively symmetrical, macular, smaller, and stable is size compared to melanoma.

Differential diagnosis includes: melanoma, dysplastic nevus, solar lentigo, freckle, and seborrheic keratoses.

A benign process that is asymptomatic.

Treatment is for cosmesis: excision, laser surgery, or intense pulsed light.

Sun avoidance is preventative.

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