Publish date: Posted on
Last updated: February 16, 2022
Keywords #
solar lentigos
sun spots
age spots
liver spots
Diagnosis #
Solar lentigos are a benign hyperpigmentation condition due to chronic or excessive sun exposure. Macules range from tan to black and are generally 3-20 mm in size, appearing in sun exposed areas such as the face, hands, arms, upper chest, and back. Lesions that have changed color, exhibit variability in color, irregular borders, or develop a papular or nodular component must be biopsied to exclude malignancy. Solar lentigos are sometimes referred to as liver spots or age spots. [1, 2]
Key Concepts #
- Benign, hyperpigmentation disorder caused by excess sun exposure.
- Commonly appear on face, shoulders, arms, hands, and upper trunk.
- Occurs more often in fair-skinned people.
- Increased incidence with age.
- No treatment required unless desired for cosmetic reasons.
- Q-switched laser, intense pulsed light therapy, tretinoin, lightening agents, and cryotherapy are all treatment options.
Epidemiology #
The incidence of solar lentigos increases with age and they are most often seen in fair skinned adults. They are found in over 90% of Caucasians by the sixth decade of life. They can also appear in fair-skinned children after significant sun exposure. Additionally, children with xeroderma pigmentosum will develop numerous solar lentigos at an early age.[1,2] Over time, some solar lentigos may develop into seborrheic keratosis.
Clinical Features #
- Flat, oval, evenly pigmented macules in areas of chronic sun exposure, particularly the face, hands, shoulders, upper trunk, and arms.
- Color can vary from tan to brown, but color in individual lesions should be uniform.
Differential Diagnoses #
- Malignant melanoma
- Lentigo maligna
- Seborrheic keratosis
- Pigmented actinic keratosis
Diagnostic Workup #
The diagnosis of solar lentigos is based on history and physical examination of the lesions. Dermoscopy may show faint pigmented fingerprint structures or a structureless pattern. Frequently, a delicate, light brown pseudo-network with well-defined borders and a “moth-eaten” edge is recognizable on facial skin.[3]
Treatment #
Treatment for solar lentigos is unnecessary except when desired for cosmetic reasons. In this case, Q-switched laser therapy or intense pulsed light therapy have been found to be effective, with topical therapies such as tretinoin, lightening agents, and cryotherapy as additional options.
References #
- Lapeere H, Boone B, De Schepper S, et al. Hypomelanoses and hypermelanoses. In: Fitzpatrick’s Dermatology in General Medicine, 8th ed, Goldsmith LA, Katz SI, Gilchrest BA, et al (Eds), McGraw-Hill, New York 2012. Vol 1.
- Ber Rahman S, Bhawan J. Lentigo. Int J Dermatol 1996; 35:229.
- 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 2015; 29:128.
