Actinic lentigo

A 72-year-old man consulted for an enlarging pigmented lesion on his right hand. This lesion was quite typical of an actinic lentigo.

Dermoscopy confirmed easily this diagnosis showing: a homogeneous pattern and a pseudoreticular network with thin lines,  with a moth-eaten border

Solar lentigos

Case 1: clinical image

The clinical aspect of a solar lentigo* is a light brown macule.
(* other denominations: lentigo actinica, senile lentigo)

Case 1: dermoscopic image

2 types of patterns can be observed:

• reticular pattern with regular meshes and thin lines
• homogeneous pattern

In all cases, the pattern has a sharp demarcation and a light brown to tan colour.

Case 2: dermoscopic image

In the 2nd case, the moth eaten borders are one of the typical aspects of solar lentigos.

Another dermoscopic feature sometimes observed is fingerprint-like structures.

Other cases: 1

Moth-eaten border

A 34-year-old patient consulted for this pigmented lesion on his face which was slowly enlarging for 2 years.


Dermoscopy was in favor of a seborrheic keratosis:

• absence of pigmented network
• moth-eaten borders (->)
• milia-like cysts
  

Scar lentigo

This 52-year-old man was operated 4 years before of a benign nevus of the lumbar area. The lesion was completely excised and pathologist concluded to a jentigo. 4 years after he consulted for this pigmentation appearing on two places of the scar. Dermoscopy revealed a faint pseudo-network of light-brown color with a moth-eaten border which was in favor of a scar lentigo. There were no signs of recurrence of a nevus or a melanoma. A follow-up was proposed.

References:
1 - D.Weedon, Skin Pathology, second edition, p 822
2 - Melanotic pigmentation in excision scars of melanocytic and non melanocytic skin tumors. Botella-Estrada et al. J Cutan Pathol 1999 Mar; 26(3):137-44