Brown spots and freckles | DermNet New Zealand Home » Topics A–Z » Brown spots and freckles Brown spots and freckles Author: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand,1997. Freckles Freckles are small flat brown marks arising on the face and other sun exposed areas. They are most often seen in fair skinned people, especially those with red hair, but they are an inherited characteristic that sometimes affects darker skin types as well. The medical term for this type of freckle is ephilis (plural ephilides). The colour is due to pigment accumulating in the skin cells (keratinocytes). Skin pigment (melanin) is made by cells called melanocytes. They don't produce much melanin during the winter months, but produce more when exposed to the sun. The melanin is diffused into the surrounding skin cells, called keratinocytes. The colour of ephilides is due to localised accumulation of melanin in keratinocytes. Ephilides are more prominent in summer but fade considerably or disappear in winter as the keratinocytes are replaced by new cells.

As the person ages this type of freckle generally become less noticeable. Apart from sun protection , no particular treatment is necessary. Freckles Lentigines Lentigines are due to localised proliferation of melanocytes. The most common type, solar lentigines, arise in middle age and also result from sun damage (age spots). They are most often found on the face and hands, and are larger and more defined than freckles. Lentigines tend to persist for long periods and don't disappear in the winter (though they may fade). The correct term for a single lesion is solar or actinic lentigo. Lentigines are common in those with fair skin but are also frequently seen in those who tan easily or have naturally dark skin. It is important to distinguish the harmless solar lentigo from an early malignant melanoma , subtypes lentigo maligna and lentiginous melanoma . If the freckle has arisen recently, is made up of more than one colour or has irregular borders or if you have any doubts, see your dermatologist for advice. It is sometimes difficult to tell a benign lentigo from a melanoma, particular if there are atypical features clinically or pathologically.

This is called atypical melanocytic hyperplasia. Such lesions should be completely removed by surgical excision with pathological examination. Lentigines Other brown marks If the brown marks are scaly, they may be actinic keratoses (sun damage) or seborrhoeic keratoses (senile warts). In this case there is a proliferation of keratinocytes. Facial pigmentation may also be due to melasma , a chronic pigmentatary disorder. Other brown marks Seborrhoeic keratosis Prevention of brown marks Not all brown marks can be prevented. Careful sun protection will reduce the number of new solar lentigines. Staying out of the sun and using sun protective clothing is much more effective than sunscreens alone. Sunscreens must have high sun protection factor (SPF 50+), good broad spectrum cover against ultraviolet radiation (UVA), and should be applied liberally and frequently. Treatment of brown marks Brown marks may fade with careful sun protection , broad spectrum sunscreen applied daily for 9 months of the year. Regular applications of anti-aging or fading creams may also help. These may contain hydroquinone , or antioxidants such as: Intense pulsed light has a similar effect.

Carbon dioxide and Erbium:YAG lasers vaporise the surface skin thus removing the pigmented lesions. A fractional laser may also be effective. Results are variable but sometimes very impressive with minimal risk of scarring. With superficial resurfacing techniques, there is minimal discomfort and no down-time but several treatments are often necessary. Unfortunately the treatment occasionally makes the pigmentation worse. Continued careful sun protection is essential, because the pigmentation is likely to recur next summer. Effect of treatment Follow-up If there is any doubt whether a brown mark may be a cancer, your doctor may choose to observe the lesion (e.g. with mole mapping or photography) or excise it for pathological examination. Related information Lentigo Medical Definition | Merriam-Webster Medical Dictionary \len-ˈtij-ə-ˌnēz\ play 1: a small melanotic spot in the skin in which the formation of pigment is unrelated to exposure to sunlight and which is potentially malignant; especially : nevus —compare freckle 2: freckle Seen and Heard What made you want to look up lentigo? Please tell us where you read or heard it (including the quote, if possible).

Lentigo Clinical Presentation: History, Physical, Causes Lentigo Clinical Presentation Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD more... Share The initial appearance of lentigines varies widely and depends on the following: Race Other factors, depending on the type of lentigo Next: The physical appearance and morphology of lentigines depend on the type of lesion. Lentigo simplex Lentigo simplex (eg, simple lentigo, juvenile lentigo) is the most common form of lentigo. Lentigo simplex is not induced by sun exposure, and it is not associated with systemic disease. Clinically, the lesions are round or oval asymptomatic macules that are 3-15 mm in diameter. Their margins can be either jagged or smooth. Pigmentation is evenly distributed, with a color ranging from brown to black. The lesions are few in number and may occur anywhere on the skin or mucous membranes. The lesions usually appear first in early childhood, but they can also be present at birth or develop later. Multiple dysplastic nevi and lentigines were reduced in number in a patient with familial gastrointestinal stromal tumors syndrome after treatment with imatinib mesylate.

[ 13 ] The effect of effect of imatinib on pigmentation is not well understood. Solar lentigo 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. [ 14 ] Ink-spot lentigo Ink-spot lentigo (ie, reticulated black solar lentigo) can be distinguished by a wiry or beaded, markedly irregular outline; these lesions occur in patients of Celtic ancestry. The benign lesions have a reticulated pattern, and most lesions resemble a spot of ink. The distribution is limited to sun-exposed areas of the body, similar to that of solar lentigo; however, in contrast to solar lentigines, patients usually have only 1 ink-spot lentigo. The most common presentation includes 1 ink-spot lentigo among an extensive number of solar lentigines. These lesions can also be distinguished from the darkly pigmented PUVA lentigo by their more reticulated or beaded pattern and multiple central and peripheral skip areas.

Ink-spot lentigines can initially suggest melanoma because of their dark color, irregular border, and limited number; however, further investigation, which may include biopsy, reveals the characteristic features of these benign lesions. PUVA lentigo PUVA lentigo is a persistent, pale brown macule appearing 6 months or longer after the start of PUVA therapy for psoriasis. The lesions resemble solar lentigines, but they often have more irregular borders and may mimic ephelides. The occurrence of lesions is closely associated with greater cumulative doses of PUVA, and the lesions may occur on all treatment sites. The most common areas include the upper part of the chest and back, groin, buttocks, glans penis, and penile shaft. The axillae, palms, soles, and gluteal cleft are spared. The lesions vary from 3-8 mm in diameter, but stellate lesions can be as large as 3 cm in diameter. The lentigines may persist for 3-6 months after therapy is discontinued. In contrast, stellate lesions can persist longer than 2 years.

Radiation lentigo Radiation lentigo resembles UV-induced lentigo, but it often includes other histopathologic signs of long-term cutaneous radiation damage such as epidermal atrophy, subcutaneous fibrosis, keratosis, and telangiectasias. The presence of a radiation lentigo is considered an indicator of a prior cutaneous exposure to a large single dose of ionizing radiation (eg, exposure during the Chernobyl nuclear accident). These lesions have not been shown to occur after local fractionated radiation therapy. Radiation lentigines are persistent and typically occur 4 months or longer after the initial exposure. The malignant potential of the lesions is unknown; however, the induction of melanoma by ionizing radiation has never been proven. Tanning-bed lentigines Tanning-bed lentigines [ 15 , 16 , 17 ] usually occur in women with a history of tanning-bed use. Tanning-bed lentigines are similar to PUVA lentigines, except psoralens are not involved. The site of tanning-bed lentigines is primarily acral despite whole-body exposure. The most common areas include the anterior aspects of the arms and legs, but they can also occur on the neck and chest.

The size of the lesions varies. The lesions are usually 2-5 mm in diameter, with color ranging from dark brown to black. Some lentigines may coalesce and enlarge. Pigmentation of the lesions may be uneven, with irregular or stellate shapes. The lesions can appear abruptly after intense tanning, or they can appear after prolonged (eg, 1 y) regular use of tanning beds. The malignant potential of the lesions is unknown. Oral and labial melanotic macules Oral and labial melanotic macules are similar to each other. Labial lesions almost always occur on the vermilion of the lower lip, and their color ranges from brown to blue to blue-black. Occasionally, variegated pigmentation occurs. The lesions are usually solitary, symmetric, and asymptomatic. Oral lesions can appear on the gingiva, buccal mucosa, palate, and tongue. Usually, oral and labial lesions have a diameter smaller than 4 mm. The individual's age at onset ranges from 25-71 years. The differential diagnosis should include Laugier-Hunziker syndrome and Peutz-Jeghers syndrome .

The absence of systemic features and involvement at other sites should assist in differentiating oral and labial melanotic macules from these syndromes. Both oral and labial melanotic macules are benign; however, lesions suggestive of malignancy should be examined at biopsy. Vulvar and penile lentigo Vulvar and penile lentigo are benign lesions similar to labial melanotic macules. In men, the most common sites are the glans penis, corona, corona sulcus, and penile shaft. The lesions vary in color from tan to brown to dark brown, and they have irregular borders and skip areas. Individual lesions may have a diameter as large as 15 mm. In women, the lesions appear anywhere on the genital mucosa as a mottled, pigmented patch with skip areas. The diameter can be 5-15 mm or larger. The lesions may also occur in episiotomy scars after childbirth. Lentigines involving the external genitalia are also reported in LAMB syndrome. Lentigines profusa Lentigines profusa (ie, generalized lentigines) is characterized by numerous lentigines without signs of associated abnormalities or triggering factors.

The clinical appearance of lentigines profusa resembles that of ephelides, but its distribution is widespread. Usual areas of involvement include the extremities, trunk, palms, and genitalia. Mucosal surfaces such as the conjunctiva can also be affected, but the buccal mucosa may be spared. The macules vary from 1 mm to 2 cm in diameter. The color of the macules ranges from dark brown to black. Lentigines profusa appears similar to the cutaneous manifestations of LEOPARD, LAMB, and NAME syndromes; however, a notable exception is the absence of the variety of the physical anomalies and defects associated with these syndromes. Agminated lentiginosis Agminated (segmental, unilateral, partial unilateral) lentiginosis is characterized by numerous lentigines confined to a body segment, with a sharp demarcation at the midline. The distribution frequently corresponds to one or more dermatomes. Less commonly, the lesions can be distributed unilaterally, bilaterally, in a checkerboard pattern, or in midline clusters. Usually, the disease appears in early childhood, although the lentigines may also be noted at birth.

These lesions have been associated with numerous diseases. Clinically, the lesions appear as circumscribed, tan or dark brown macules on healthy background skin. Xeroderma pigmentosum Xeroderma pigmentosum (XP) is an autosomal-recessive condition involving abnormalities that stem from an inability of cells to repair DNA damage induced by exposure to UV light and certain chemicals. Clinically, patients have skin atrophy and progressive pigmentary changes. Subsequently, neoplastic changes occur on the skin, often in childhood; squamous cell and basal cell carcinomas are the most common malignancies. Other cancers, such as melanoma, may appear as well. All of these neoplastic changes evolve on sun-exposed areas, particularly the head, neck, and face. XP is diagnosed in young children, who are typically healthy. Children should avoid sun exposure because the acceleration of skin changes leads to the formation of neoplasms. Ocular and neurologic defects are also associated with XP. See the image below. Thirteen-year-old Greek adolescent with xeroderma pigmentosum.

View Media Gallery LEOPARD syndrome LEOPARD syndrome (lentigines, electrocardiographic conduction defects, ocular hypertelorism, pulmonary stenosis, abnormal genitalia, retardation of growth, and deafness syndrome) (ie, multiple lentigines syndrome) is a complex dysmorphogenetic disorder that is transmitted as an autosomal-dominant trait with variable penetrance. A mutation of the PTPN11 gene may be documented. [ 18 ] The diagnosis can be difficult because most patients have only 3-5 of the criteria. Lentigines are the most common feature of the syndrome, although they do not have to be present to diagnose LEOPARD syndrome. In the absence of lentigines, the diagnosis can be made if the patient has 3 features of the disease and an immediate relative with the disease. Lentigines are present at birth and increase in number until puberty. The intensity of the pigmentation varies. The lesions are numerous on the neck and trunk, but they can also be widespread and involve the genitalia, palms, soles, and scalp. Lentigines spare some parts of the face and may be limited to one side of the body in some cases.

Peutz-Jeghers syndrome Peutz-Jeghers syndrome is an autosomal-dominant condition with a high degree of penetrance and is characterized by gastrointestinal polyps and pigmented macules. The polyps are benign hamartomas that can affect the entire bowel, most characteristically the jejunum. These polyps result in recurrent perirectal bleeding and abdominal pain. Patients are often first seen with bleeding or with intussusception that manifests as an obstruction, abdominal pain, rectal prolapse, vomiting, and/or currant jelly–like stool. Lentigines are brown-to-black-to-blue macules that usually arise in early childhood. Their size ranges from 1-12 mm in diameter. Hyperpigmented macules occur in more than 95% of patients, and they have a characteristic distribution around the mouth, on the lips, and on the buccal mucous membranes; they can also be scattered around the nose and face. Additionally, lesions appear on the fingers and toes on both the palmar and volar surfaces. Lesions are characteristically absent on the flexor and extensor surfaces of the rest of the body.

The buccal mucosal macules are important because they persist, whereas the other macules may fade with age. A relationship between the extent of melanosis and the extent of polyposis has not been found. Almost all women have unusual sex cord tumors that are small, bilateral, asymptomatic, and multifocal. Gonadal tumors are also noted in men. Women have an increased risk of breast cancer, either unilateral or bilateral in presentation. Laugier-Hunziker syndrome Laugier-Hunziker syndrome is characterized by a variable number of pigmented macules that most commonly appear on the lower lip; buccal mucosa; hard palate; and, occasionally, tips of the fingers. Other locations include the labial commissure, tongue, gums, floor of the mouth, neck, thorax, abdomen, nails, and soles. The lentigines may be numerous and confluent, but they rarely occur in a linear pattern. The lesions mostly occur on the nails. Their borders are smooth and well defined. The color of the lesions can vary from gray to brown, blue, or black. Although the syndrome has a chronic course without remission, individuals are generally asymptomatic.

This syndrome differs from Peutz-Jeghers syndrome because of the absence of intestinal polyps. Laugier-Hunziker syndrome occurs in individuals aged 20-50 years and in both sexes, whereas isolated labial melanotic macules affect younger patients and are usually solitary. Pigmentation of the oral mucosa and nails is reported to occur in patients taking the antiretroviral medication zidovudine. The clinical and drug histories are important in differentiating this phenomenon from Laugier-Hunziker disease. Myxoma syndrome The myxoma syndrome is associated with mucocutaneous lentigines along with various additional abnormalities. Some constellations of abnormalities have been given specific names. They may all be part of a spectrum of manifestations of the same disorder. LAMB syndrome LAMB (lentigines, atrial myxomas, mucocutaneous myxomas, and blue nevi) syndrome is one of the myxoma syndromes. The lentigines most commonly occur on the lips, face, sclera, and vulva. The lesions are brown and can be as large as 1 cm in diameter.

The mucocutaneous myxomas appear as papules or dermal nodules at various sites on the body, including the breasts, shoulders, oral mucosa, and tongue. Cardiac myxomas are rare in children and usually occur in the form of atrial myxomas, which are clinically evident as intermittent embolic episodes and valvular obstructions. An association with benign thyroid nodules is noted. NAME syndrome NAME (nevi, atrial myxoma, myxoid neurofibroma, and ephelides) syndrome is another myxoma syndrome. This possible variant of LAMB syndrome involves multiple, flat, pigmented macules. The lesions begin at birth and are accentuated in the summer. The color of the lesions varies from pale to dark brown. The most commonly involved areas are the neck, trunk, and thighs. The palms and soles are sometimes affected. Carney syndrome Carney syndrome is an autosomal dominant multiple neoplasia syndrome involving cardiac, cutaneous, and mammary myxomatous masses; lentigines; blue nevi; endocrine disorders; and testicular tumors. [ 19 ] Often, multicentric and bilateral organ involvement is present; this usually occurs in young patients.

The cutaneous myxomas are often observed on the eyelids and other sites such as the nipples, scalp, face, oral mucosa, ears, neck, trunk, limbs, and perineum. Cardiac myxomas are either single or multiple and often result in fibrosis or calcification. Two types of pigmented macules exist: blue nevi and lentigines. Lentigines are brown to black and 0.2-2 mm in diameter; they have irregularly shaped, jagged margins. They are widespread throughout the body and may coalesce to form brown patches. The lesions can be found on the face, eyelids, ears, vermilion borders of the lips, conjunctiva, vulva, extremities, and glans penis. Unlike Peutz-Jeghers syndrome, Carney syndrome infrequently involves buccal lesions. Endocrine involvement includes calcifying pigmented neuroectodermal tumors, pituitary adenomas with acromegaly and gigantism, and adrenocortical disease leading to Cushing syndrome. Testicular tumors feature Sertoli cell tumors, Leydig cell tumors, and adrenocortical rest tumors.

Mammary involvement includes gynecomastia and myxomatous enlargement of the stroma. Inherited patterned lentiginosis Inherited patterned lentiginosis can occur in blacks. This form is characterized by hyperpigmented macules on the face and lips. At times, additional lesions are seen on the elbows, knees, buttocks, and palmoplantar surfaces. Lesions are not present on the oral mucosa, and they are not associated with organ involvement or an apparent risk of cancer. The inheritance pattern appears to be autosomal dominant. Light-skinned African American families, some of whom have a mixed American Indian heritage and those with relatives with red hair, are particularly affected. See the image below. Ephelides (ie, freckles) on the forearm of a 26-year-old redheaded patient. View Media Gallery Nevus spilus The nevus spilus is a both a lentigo and melanocytic nevus, a unique neoplasm that has only a slight potential to develop into melanoma. [ 20 ] It is evident as multiple pigmented macules or papules within a congenital or acquired pigmented patch.

Previous Lentigo Treatment & Management: Medical Care, Surgical Care, Complications Lentigo Treatment & Management Author: Robert A Schwartz, MD, MPH; Chief Editor: William D James, MD more... Share Treatment Medical Care Noninvasive topical creams are also used. After several months of application, tretinoin cream and hydroquinone cream can lighten lentigines. The efficacy and safety of cryotherapy and trichloroacetic acid (TCA) were compared for the treatment of solar lentigo. [ 32 ] Cryotherapy was more effective than TCA 33% solution in the treatment of solar lentigines of the back of the hands, particularly in lighter-complexioned individuals. For darker-complexioned people, TCA 33% may be preferred, although postinflammatory hyperpigmentation remains a risk for both modalities. A triple combination cream with fluocinolone acetonide 0.01%, hydroquinone 4%, and tretinoin 0.05% as adjuvant to cryotherapy for solar lentigines on the dorsal hands was found to be effective.

[ 33 ] The effect of a bleaching solution containing 2% mequinol (4-hydroxyanisole, 4HA) and 0.01% tretinoin (Solagé) applied twice daily for 3 months on solar lentigines present on the back of one hand demonstrated a significant lightening effect after 2 months of treatment and was maintained at least 2 months after stopping treatment. [ 34 ] Skin-lightening products commercially available target natural melanin production, many as competitive inhibitors of tyrosinase. [ 35 ] Phalaenopsis orchid extract may be useful as a novel treatment of solar lentigines. [ 36 ] Next: Surgical Care Treatment of solar lentigines with a focal medium-depth chemical peel may be clinically superior to treatment with cryosurgery, owing to the paucity of adverse effects (eg, hypopigmentation, pain) associated with chemical peels. [ 37 ] Cryosurgery [ 38 ] is a simple treatment for isolated lentigines. Many consider the first-line therapy for solar lentigines to be ablative therapy with cryotherapy.

[ 39 ] This procedure is often successful because of the susceptibility of melanocytes to freezing with liquid nitrogen. Squamous cells resist injury at -20°C, whereas melanocytes freeze at -4 to -7°C. Lasers are effective in the treatment of various lentigines. The development of short-pulsed, pigment-specific lasers to selectively destroy the pigment within the solar lentigo has led to significant clinical improvement, a low risk of adverse effects, and high patient acceptance. [ 40 ] The frequency-doubled, Q-switched Nd:YAG laser, [ 41 ] the HGM K1 krypton laser, and the 532-nm diode-pumped vanadate laser are all used with success. [ 42 ] Use of a low-fluence 1,064-nm Q-switched neodymium-doped yttrium aluminum garnet (QS Nd:YAG) laser is another choice. [ 43 ] Treatment with Q-switched Nd:YAG laser may work better than fractional carbon dioxide laser for solar lentigines. [ 44 ] Intense pulsed-light (IPL) treatment is another option.

[ 45 ] Previous References Derancourt C, Bourdon-Lanoy E, Grob JJ, Guillaume JC, Bernard P, Bastuji-Garin S. Multiple large solar lentigos on the upper back as clinical markers of past severe sunburn: a case-control study. Dermatology. 2007. 214(1):25-31. [Medline] . Byrom L, Barksdale S, Weedon D, Muir J. Unstable solar lentigo: A defined separate entity. Australas J Dermatol. 2016 Feb 2. [Medline] . Aoki H, Moro O, Tagami H, Kishimoto J. Gene expression profiling analysis of solar lentigo in relation to immunohistochemical characteristics. Br J Dermatol. 2007 Jun. 156(6):1214-23. [Medline] . Hafner C, Stoehr R, van Oers JM, et al. FGFR3 and PIK3CA mutations are involved in the molecular pathogenesis of solar lentigo. Br J Dermatol. 2009 Mar.

160(3):546-51. [Medline] . Vierkötter A, Krämer U, Sugiri D, Morita A, Yamamoto A, Kaneko N, et al. Development of lentigines in German and Japanese women correlates with variants in the SLC45A2 gene. J Invest Dermatol. 2012 Mar. 132(3 Pt 1):733-6. [Medline] . Samuelov L, Sarig O, Gat A, Halachmi S, Shalev S, Sprecher E. Extensive lentigo simplex, linear epidermolytic naevus and epidermolytic naevus comedonicus caused by a somatic mutation in KRT10. Br J Dermatol. 2014 Dec 15. [Medline] . Hansen LK, Risby K, Bygum A, Gerdes AM. [LEOPARD syndrome]. Ugeskr Laeger. 2009 Jan 19. 171(4):247. [Medline] .

LaRosa CL, Foulke GT, Feigenbaum DF, Cordoro KM, Zaenglein AL. Lentigines in resolving psoriatic plaques: rarely reported sequelae in pediatric cases. Pediatr Dermatol. 2015 May. 32 (3):e114-7. [Medline] . Alper JC, Holmes LB. The incidence and significance of birthmarks in a cohort of 4,641 newborns. Pediatr Dermatol. 1983 Jul. 1(1):58-68. [Medline] . Kavak A, Parlak AH, Yesildal N, Aydogan I, Anul H. Preliminary study among truck drivers in Turkey: effects of ultraviolet light on some skin entities. J Dermatol. 2008 Mar. 35(3):146-50. [Medline] . O'Neill JF, James WD. Inherited patterned lentiginosis in blacks. Arch Dermatol. 1989 Sep. 125(9):1231-5. [Medline] . Bolognia JL.

Reticulated black solar lentigo ('ink spot' lentigo). Arch Dermatol. 1992 Jul. 128(7):934-40. [Medline] . Campbell T, Felsten L, Moore J. Disappearance of lentigines in a patient receiving imatinib treatment for familial gastrointestinal stromal tumor syndrome. Arch Dermatol. 2009 Nov. 145(11):1313-6. [Medline] . Pollefliet C, Corstjens H, González S, Hellemans L, Declercq L, Yarosh D. Morphological characterization of solar lentigines by in vivo reflectance confocal microscopy: a longitudinal approach. Int J Cosmet Sci. 2013 Apr. 35(2):149-55. [Medline] . Roth DE, Hodge SJ, Callen JP. Possible ultraviolet A-induced lentigines: a side effect of chronic tanning salon usage. J Am Acad Dermatol. 1989 May. 20(5 Pt 2):950-4. [Medline] .

Salisbury JR, Williams H, du Vivier AW. Tanning-bed lentigines: ultrastructural and histopathologic features. J Am Acad Dermatol. 1989 Oct. 21(4 Pt 1):689-93. [Medline] . Williams HC, Salisbury J, Brett J, du Vivier A. Sunbed lentigines. Br Med J (Clin Res Ed). 1988 Apr 16. 296(6629):1097. [Medline] . [Full Text] . Lin IS, Wang JN, Chao SC, Wu JM, Lin SJ. PTPN11 mutations in LEOPARD syndrome: report of four cases in Taiwan. J Formos Med Assoc. 2009 Oct. 108(10):803-7. [Medline] . Horvath A, Stratakis CA. Carney complex and lentiginosis. Pigment Cell Melanoma Res. 2009 Oct. 22(5):580-7. [Medline] . Vaidya DC, Schwartz RA, Janniger CK. Nevus spilus.

Cutis. 2007 Dec. 80(6):465-8. [Medline] . Hickey JR, Robson A, Barker JN, Smith CH. Does topical tacrolimus induce lentigines in children with atopic dermatitis? A report of three cases. Br J Dermatol. 2005 Jan. 152(1):152-4. [Medline] . Basarab T, Millard TP, McGregor JM, Barker JN. Atypical pigmented lesions following extensive PUVA therapy. Clin Exp Dermatol. 2000 Mar. 25(2):135-7. [Medline] . Miller RA. Psoralens and UV-A-induced stellate hyperpigmented freckling. Arch Dermatol. 1982 Aug. 118(8):619-20. [Medline] . Rhodes AR, Harrist TJ, Momtaz-T K. The PUVA-induced pigmented macule: a lentiginous proliferation of large, sometimes cytologically atypical, melanocytes. J Am Acad Dermatol. 1983 Jul.

9(1):47-58. [Medline] . Peter RU, Gottlober P, Nadeshina N, Krahn G, Plewig G, Kind P. Radiation lentigo. A distinct cutaneous lesion after accidental radiation exposure. Arch Dermatol. 1997 Feb. 133(2):209-11. [Medline] . Tanaka M, Sawada M, Kobayashi K. Key points in dermoscopic differentiation between lentigo maligna and solar lentigo. J Dermatol. 2011 Jan. 38(1):53-8. [Medline] . Lallas A, Argenziano G, Moscarella E, Longo C, Simonetti V, Zalaudek I. Diagnosis and management of facial pigmented macules. Clin Dermatol. 2014 Jan-Feb. 32(1):94-100. [Medline] . Fraga GR, Amin SM. Large cell acanthoma: a variant of solar lentigo with cellular hypertrophy. J Cutan Pathol. 2014 Sep.

41(9):733-9. [Medline] . Zaballos P, Rodero J, Pastor L, Vives JM, Puig S, Malvehy J. Dermoscopy of lichenoid regressing solar lentigines. Arch Dermatol. 2008 Feb. 144(2):284. [Medline] . Shin J, Park JY, Kim SJ, Kang HY. Characteristics of keratinocytes in facial solar lentigo with flattened rete ridges: comparison with melasma. Clin Exp Dermatol. 2015 Feb 22. [Medline] . Unver N, Freyschmidt-Paul P, Horster S, et al. Alterations in the epidermal-dermal melanin axis and factor XIIIa melanophages in senile lentigo and ageing skin. Br J Dermatol. 2006 Jul. 155(1):119-28. [Medline] . Raziee M, Balighi K, Shabanzadeh-Dehkordi H, Robati RM. Efficacy and safety of cryotherapy vs.

trichloroacetic acid in the treatment of solar lentigo. J Eur Acad Dermatol Venereol. 2008 Mar. 22(3):316-9. [Medline] . Hexsel D, Hexsel C, Porto MD, Siega C. Triple combination as adjuvant to cryotherapy in the treatment of solar lentigines: investigator-blinded, randomized clinical trial. J Eur Acad Dermatol Venereol. 2014 Mar 31. [Medline] . Pierard-Franchimont C, Henry F, Quatresooz P, Vroome V, Pierard GE. Analytic quantification of the bleaching effect of a 4-hydroxyanisole-tretinoin combination on actinic lentigines. J Drugs Dermatol. 2008 Sep. 7(9):873-8. [Medline] . Gillbro JM, Olsson MJ. The melanogenesis and mechanisms of skin-lightening agents - existing and new approaches. Int J Cosmet Sci. 2011 Jun. 33(3):210-21. [Medline] .

Yamada T, Hasegawa S, Inoue Y, Kunita M, Ohsumi K, Sakaida T, et al. Inhibitory effect of Phalaenopsis orchid extract on WNT1-induced immature melanocyte precursor differentiation in a novel in vitro solar lentigo model. Biosci Biotechnol Biochem. 2016 Mar 4. 1-6. [Medline] . Sezer E, Erbil H, Kurumlu Z, Tastan HB, Etikan I. A comparative study of focal medium-depth chemical peel versus cryosurgery for the treatment of solar lentigo. Eur J Dermatol. 2007 Jan-Feb. 17(1):26-9. [Medline] . Leroy D, Dompmartin A, Dubreuil A, Louvet S. Cryotherapy of PUVA lentigines. Br J Dermatol. 1996 Dec. 135(6):988-90. [Medline] . Ortonne JP, Pandya AG, Lui H, Hexsel D. Treatment of solar lentigines. J Am Acad Dermatol.

2006 May. 54(5 Suppl 2):S262-71. [Medline] . Bukvic Mokos Z, Lipozencic J, Pasic A, Fattorini I. Laser therapy for solar lentigines: review of the literature and case report. Acta Dermatovenerol Croat. 2006. 14(2):81-5. [Medline] . Todd MM, Rallis TM, Gerwels JW, Hata TR. A comparison of 3 lasers and liquid nitrogen in the treatment of solar lentigines: a randomized, controlled, comparative trial. Arch Dermatol. 2000 Jul. 136(7):841-6. [Medline] . Chan HH, Fung WK, Ying SY, Kono T. An in vivo trial comparing the use of different types of 532 nm Nd:YAG lasers in the treatment of facial lentigines in Oriental patients. Dermatol Surg. 2000 Aug. 26(8):743-9. [Medline] . Lee Y, Choi EH, Lee SW.

Low-fluence Q-switched 1,064-nm neodymium-doped yttrium aluminum garnet laser for the treatment of facial partial unilateral lentiginosis in Koreans. Dermatol Surg. 2012 Jan. 38(1):31-7. [Medline] . Vachiramon V, Panmanee W, Techapichetvanich T, Chanprapaph K. Comparison of Q-switched Nd: YAG laser and fractional carbon dioxide laser for the treatment of solar lentigines in Asians. Lasers Surg Med. 2016 Apr. 48 (4):354-9. [Medline] . Campolmi P, Bonan P, Cannarozzo G, et al. Intense pulsed light in the treatment of non-aesthetic facial and neck vascular lesions: report of 85 cases. J Eur Acad Dermatol Venereol. 2011 Jan. 25(1):68-73. [Medline] . Media Gallery Thirteen-year-old Greek adolescent with xeroderma pigmentosum.

Ephelides (ie, freckles) on the forearm of a 26-year-old redheaded patient. Woman with solar lentigo. Close-up view of a woman with solar lentigo. of 4 Noonan syndrome with multiple lentigines - Genetics Home Reference Noonan syndrome with multiple lentigines Description Noonan syndrome with multiple lentigines (formerly called LEOPARD syndrome) is a condition that affects many areas of the body. As the condition name suggests, Noonan syndrome with multiple lentigines is very similar to a condition called Noonan syndrome , and it can be difficult to tell the two disorders apart in early childhood. However, the features of these two conditions differ later in life. The characteristic features of Noonan syndrome with multiple lentigines include brown skin spots called lentigines that are similar to freckles, heart defects, widely spaced eyes ( ocular hypertelorism ), a sunken chest (pectus excavatum) or protruding chest (pectus carinatum), and short stature. These features vary, however, even among affected individuals in the same family. Not all individuals with Noonan syndrome with multiple lentigines have all the characteristic features of this condition.

The lentigines seen in Noonan syndrome with multiple lentigines typically first appear in mid-childhood, mostly on the face, neck, and upper body. Affected individuals may have thousands of small dark brown skin spots by the time they reach puberty. Unlike freckles, the appearance of lentigines has nothing to do with sun exposure. In addition to lentigines, people with this condition may have lighter brown skin spots called café-au-lait spots. Café-au-lait spots tend to develop before the lentigines, appearing within the first year of life in most affected people. Of the people with Noonan syndrome with multiple lentigines who have heart defects, about 80 percent have hypertrophic cardiomyopathy , which is a thickening of the heart muscle that forces the heart to work harder to pump blood. The hypertrophic cardiomyopathy most often affects the lower left chamber of the heart ( the left ventricle ). Up to 20 percent of people with Noonan syndrome with multiple lentigines who have heart problems have a narrowing of the artery from the heart to the lungs (pulmonary stenosis). People with Noonan syndrome with multiple lentigines can have a distinctive facial appearance.

In addition to ocular hypertelorism, affected individuals may have droopy eyelids ( ptosis ), thick lips, and low-set ears. Affected individuals also usually have an abnormal appearance of the chest; they either have pectus excavatum or pectus carinatum. At birth, people with Noonan syndrome with multiple lentigines are typically of normal weight and height, but in some, growth slows over time. This slow growth results in affected individuals being shorter than average, although less than half of people with Noonan syndrome with multiple lentigines have significantly short stature. Other signs and symptoms of Noonan syndrome with multiple lentigines include hearing loss caused by abnormalities in the inner ear (sensorineural deafness), mild intellectual disability, and extra folds of skin on the back of the neck. Affected males often have genital abnormalities, which can include undescended testes (cryptorchidism) and a urethra that opens on the underside of the penis (hypospadias). These abnormalities may reduce the ability to have biological children (decreased fertility). Females with Noonan syndrome with multiple lentigines may have poorly developed ovaries and delayed puberty.

Noonan syndrome with multiple lentigines is one of a group of related conditions collectively known as RASopathies. These conditions all have similar signs and symptoms and are caused by changes in the same cell signaling pathway. In addition to Noonan syndrome with multiple lentigines, the RASopathies include Noonan syndrome, cardiofaciocutaneous syndrome , Costello syndrome , neurofibromatosis type 1 , and Legius syndrome . Related Information Genetic Changes Mutations in one of several genes can cause Noonan syndrome with multiple lentigines. Approximately 85 percent of individuals with this condition have mutations in the PTPN11 gene. Another 10 percent have mutations in the RAF1 gene. In rare cases, mutations in the BRAF or MAP2K1 gene have been found to cause this condition. The remaining individuals with Noonan syndrome with multiple lentigines do not have an identified mutation in any of these four genes. In these individuals, the cause of the condition is unknown. The PTPN11, RAF1, BRAF, and MAP2K1 genes all provide instructions for making proteins that are involved in important signaling pathways needed for the proper formation of several types of tissue during development.

These proteins also play roles in the regulation of cell division , cell movement (migration), and cell differentiation (the process by which cells mature to carry out specific functions). A mutation in the PTPN11, RAF1, BRAF, or MAP2K1 gene leads to the production of a protein that functions abnormally, which impairs the protein's ability to respond to cell signals. A disruption in the regulation of systems that control cell growth and division leads to the characteristic features of Noonan syndrome with multiple lentigines. Lentigo | DermNet New Zealand DermNet New Zealand Author: Vanessa Ngan, Staff Writer, 2006. Updated by A/Prof Amanda Oakley, February 2016. What is a lentigo? A lentigo is a pigmented flat or slightly raised lesion with a clearly defined edge. Unlike an ephilis (freckle), it does not fade in the winter months. There are several kinds of lentigo. The name lentigo originally referred to its appearance resembling a small lentil. The plural of lentigo is lentigines, although “lentigos” is also in common use. Who gets lentigines?

Lentigines can affect males and females of all ages and races. Solar lentigines are especially prevalent in fair skinned adults. Lentigines associated with syndromes are present at birth or arise during childhood. What causes lentigines? Common forms of lentigo are due to exposure to ultraviolet radiation: Sun damage including sunburn Phototherapy , especially photochemotherapy ( PUVA ) Ionising radiation, eg radiation therapy , can also cause lentigines. Several familial syndromes associated with widespread lentigines originate from mutations in Ras-MAP kinase, mTOR signalling and PTEN pathways. What are the clinical features of lentigines? Lentigines have been classified into several different types depending on what they look like, where they appear on the body, causative factors, and whether they are associated to other diseases or conditions. Lentigines may be solitary or more often, multiple. Most lentigines are smaller than 5 mm in diameter.

Lentigo simplex A precursor to junctional naevus Arises during childhood and early adult life Found on trunk and limbs Small brown round or oval macule or thin plaque Jagged or smooth edge May have a dry surface May disappear in time A precursor to seborrhoeic keratosis Found on chronically sun exposed sites such as hands, face, lower legs May also follow sunburn to shoulders Yellow, light or dark brown regular or irregular macule or thin plaque May have a dry surface Often has moth-eaten outline Can slowly enlarge to several centimetres in diameter May disappear, often through the process known as lichenoid keratosis Solar lentigo Also known as reticulated lentigo Few in number compared to solar lentigines Follows sunburn in very fair skinned individuals Dark brown to black irregular ink spot-like macule Ink spot lentigo Similar to ink spot lentigo but follows photochemotherapy (PUVA) Location anywhere exposed to PUVA PUVA lentigo Similar to ink spot lentigo but follows indoor tanning Location anywhere exposed to tanning bed Tanning bed lentigo Lentigines - definition of lentigines by The Free Dictionary Lentigines - definition of lentigines by The Free Dictionary Related to lentigines:

 Solar lentigines len·ti·go n.

pl. len·tig·i·nes (-tĭj′ə-nēz′) A small, flat, pigmented spot on the skin. [Latin lentīgō, lentīgin-, from lēns, lent-, lentil.] len·tig′i·nous (-tĭj′ə-nəs), len·tig′i·nose′ (-nōs′) adj. lentigo (Medicine) a technical name for a freckle [C14: from Latin, from lēns lentil] lenˈtiginous, lenˈtiginose adj n., pl. -tig•i•nes (-ˈtɪdʒ əˌniz) a freckle or other pigmented spot. [1375–1425; late Middle English < Latin, =lentī-, lengthened s. of lēns lentil (see lens ) + -gō n.

suffix] ThesaurusAntonymsRelated WordsSynonymsLegend: cutis , skin , tegument - a natural protective body covering and site of the sense of touch; "your skin is the largest organ of your body" macule , macula - a patch of skin that is discolored but not usually elevated; caused by various diseases Translations n. léntigo, mácula de la piel; malignant ___ → ___ maligno; lentigo n lentigo Want to thank TFD for its existence? Tell a friend about us , add a link to this page, or visit the webmaster's page for free fun content . Link to this page: tegument References in periodicals archive ? The inhibition of tyrosinase can play a key role in the management of diseases such as cutaneous hyperpigmentation disorders such as lentigines (freckles, age spots and liver spots), and possibly melanoma.

RXi Pharmaceuticals Reports Second Quarter 2015 Financial Results and Business Highlights Melanin is essential for protecting human skin against radiation, but the accumulation of abnormal melanin induces pigmentation disorders, such as melasma, freckles, ephelide, and senile lentigines (Rees 2003). Topical vitamins, minerals and botanical ingredients as modulators of environmental and chronological skin damage For example, he said that East Asians' skin aging concerns include solar lentigines, facial seborrheic keratoses, melasma and fine lines and wrinkles. One for the ages: HAPPI'S Anti-Aging Conference & Tabletop Exhibition attracted nearly 300 industry executives who heard from leading dermatologists, regulators and analysts Over exposure to harmful ultra violet light can also cause conditions including Lentigines, commonly known as sun spots; Seborrheic Keratosis, a benign wart-like growth which appears on the face and chest; and Actinic Keratosis, a precancerous growth which can appear in the form of dry skin lesions or patches on the skin.

Skin Conditions: Moles, Skin Tags & More | Cleveland Clinic There are several skin lesions that are very common and almost always benign (non-cancerous). These conditions include moles , freckles, skin tags, benign lentigines, and seborrheic keratoses. What is a mole? Moles are growths on the skin that are usually brown or black. Moles can appear anywhere on the skin, alone or in groups. Most moles appear in early childhood and during the first 20 years of a person's life. Some moles might not appear until later in life. It is normal to have between 10 to 40 moles by adulthood. As the years pass, moles usually change slowly, becoming raised and lighter in color. Often, hairs develop on the mole. Some moles will not change at all, while others will slowly disappear over time. What causes a mole? Moles occur when cells in the skin grow in a cluster instead of being spread throughout the skin. These cells are called melanocytes, and they make the pigment that gives skin its natural color. Moles might darken after exposure to the sun, during the teen years, and during pregnancy .

What should I look for when examining my moles? Most moles are benign. The only moles that are of medical concern are those that look different than other existing moles or those that first appear after age 20. If you notice changes in a mole's color, height, size, or shape, you should have a dermatologist (skin doctor) evaluate it. You also should have moles checked if they bleed, ooze, itch, appear scaly, or become tender or painful. Examine your skin with a mirror or ask someone to help you. Pay special attention to areas of your skin that are often exposed to the sun, such as the hands, arms, chest, neck, face, and ears. If your moles do not change over time, there is little reason for concern. If you see any signs of change in an existing mole, if you have a new mole, or if you want a mole to be removed for cosmetic reasons, talk to your dermatologist. The following ABCDEs are important signs of moles that could be cancerous.

If a mole displays any of the signs listed below, have it checked immediately by a dermatologist: Asymmetry: One half of the mole does not match the other half. Border: The border or edges of the mole are ragged, blurred, or irregular. Color: The color of the mole is not the same throughout or has shades of tan, brown, black, blue, white, or red. Diameter: The diameter of a mole is larger than the eraser of a pencil. Elevation/Evolution: A mole appears elevated, or raised from the skin. Are the moles changing over time? Melanoma is a form of skin cancer. The most common location for melanoma in men is the back; in women, it is the lower leg. Melanoma is the most common cancer in women ages 25 to 29. What are the different types of moles? Congenital nevi are moles that appear at birth. Congenital nevi occur in about one in 100 people. These moles might be more likely to develop into melanoma than are moles that appear after birth. If the mole is more than eight inches in diameter, it poses more risk of becoming cancerous.

Dysplastic nevi are moles that are larger than average (larger than a pencil eraser) and irregular in shape. They tend to have uneven color with dark brown centers and lighter, uneven edges. These moles tend to be hereditary. People with dysplastic nevi might have more than 100 moles and have a greater chance of developing malignant (cancerous) melanoma. Any changes in the mole should be checked by a dermatologist to detect skin cancer. How are moles treated? If a dermatologist believes the mole needs to be evaluated further or removed entirely, he or she will first take a biopsy (small tissue sample of the mole) to examine thin sections of the tissue under a microscope. This is a simple procedure. (If the dermatologist thinks the mole might be cancerous, cutting through the mole will not cause the cancer to spread.) If the mole is found to be cancerous, the dermatologist will remove the entire mole by cutting out the entire mole and a rim of normal skin around it, and stitching the wound closed. What is a skin tag? A skin tag is a small flap of tissue that hangs off the skin by a connecting stalk. Skin tags are benign and are not dangerous.

They are usually found on the neck, chest, back, armpits, under the breasts, or in the groin area. Skin tags appear most often in women, especially with weight gain, and in middle-aged and elderly people. Skin tags usually don’t cause any pain. However, they can become irritated if anything such as clothing or jewelry rubs on them. How are skin tags treated? Your dermatologist can remove a skin tag by cutting it off with a scalpel or scissors, with cryotherapy (freezing it off), or with electrosurgery (burning with an electric current). What is a lentigo? A lentigo (plural: lentigines) is a spot on the skin that is darker (usually brown) than the surrounding skin. Lentigines are more common among Caucasian patients, especially those with fair skin, but can occur in anyone. What are the causes of lentigines? Exposure to the sun seems to be the major cause of lentigines. Lentigines most often appear on parts of the body that get the most sun, including the face and hands. Some lentigines might be caused by genetics (family history) or by medical procedures such as radiation therapy . How are lentigines treated?

There are several methods for treating lentigines: Cryotherapy (freezing it off) Creams that are applied to the skin (These include retinoids and bleaching agents.) Can lentigines be prevented? The best way to prevent lentigines is to stay out of the sun as much as possible. Use sunscreen when outdoors, and avoid using a tanning bed to get a suntan. What are freckles? Freckles are small brown spots usually found on the face and arms. Freckles are extremely common and are not a health threat. They are more often seen in the summer, especially among lighter-skinned people and people with light or red hair. However, freckles can occur in anyone, and appear as darker brown spots in people with darker skin. Both men and women get freckles at an equal rate. What causes freckles? Causes of freckles include genetics, diseases (such as xeroderma pigmentosum, a rare disease that causes an increased sensitivity to ultraviolet light, such as the sun), and exposure to the sun. What is the treatment for freckles? Since freckles are almost always harmless, there really is no need to treat them.

As with many skin conditions, it’s best to avoid the sun as much as possible, or use a sunscreen. This is especially important because people who freckle easily (such as lighter-skinned people) are more likely to develop skin cancer. If you feel that your freckles are a problem or you don’t like the way they look, you can cover them up with makeup. What are seborrheic keratoses? Seborrheic keratoses are brown or black growths usually found on the chest and back, as well as on the head. They originate from cells called keratinocytes. As they develop, seborrheic keratoses take on a warty appearance. What causes seborrheic keratoses? The cause of seborrheic keratoses is unknown. They are seen more often as people get older. They do not lead to skin cancer. How are seborrheic keratoses treated? Seborrheic keratoses are benign and are not contagious. Therefore, they don’t need to be treated.

If you decide to have seborrheic keratoses removed because you don’t like the way they look, or because they are chronically irritated by clothing, methods for removing them include cutting them off, cryotherapy, and electrosurgery. Can seborrheic keratoses be prevented? Seborrheic keratoses can’t be prevented. References: National Institute on Aging. AgePage: skin care and aging . Accessed 2/24/2016. Woodhouse JG, Tomecki KJ. Common benign growths. In: Carey WD, ed. Cleveland Clinic: Current Clinical Medicine 2010. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2010:section 3. © Copyright 1995-2016 The Cleveland Clinic Foundation. All rights reserved. This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 5/23/2014...#12014

Question: Lentigines is the medical name for what?
Answer: FRECKLES