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Solar lentigines

1455

Known as age spots, liver spots or senile lentigines.

Usually multiple light to dark brown hyper pigmented macules found mainly on sun-exposed areas of the skin.

Predilection for the face and forearms.

Not true lentigines.

Epidermal proliferations that often are first signs of photoaging of the skin.

Reflects accumulation of melanin.

Incidence increases with age.

Affects more than 90% of white individuals over the age of 50 years.

Can be confused with a variety of other skin lesions and biopsy may be required to clarify the diagnosis.

Treatment includes topical and ablative methods.

Topical therapies take longer to improve than do ablative treatments but the risk of side effects is less.

Topical agents include hydroquinone or retinoic acid which may used alone or together.

Hydroquinone inhibits conversion of dopa to melanin by inhibiting activity of tyrosinase.

Retinoic acid causes desquamation and may inhibit tyrosinase activity.

Improvement with topical treatment in approximately 80% of patients.

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