Solar lentigo (Actinic lentigo)

Deba P Sarma, MD
Omaha
F 71, left dorsal forearm
 Comment
 Location: Sun-exposed areas-face, forearms, dorsal hand.
Age: Rare before 50. After 70, more than 90% people with light skin
may have solar lentigo.
Clinical: Uniform, dark brown, non-infiltrated macule of irregular
outline, size: minute to > 1cm.
MIcroscopic features:
-Flat epidermis.
-Acanthosis with elongated rete ridges with club-shaped, tortuous or
bud-like extensions.
-Elongated rete ridges are composed of pigmented basaloid cells.
Melanocytes are normal or increased in number.
-No melanocytic nests present at the junction.
-Dermis shows actinic degeneration.
( DO NOT DIAGNOSE SOLAR LENTIGO IF THE DERMIS DOES
NOT SHOW SOLAR DEGENERATION)
Solar lentigo is not a melanocytic disorder.
Solar lentigo may evolve into reticulated pigmented seborrheic
keratosis with raised epidermis.
Solar lentigo is usually not a precursor of any malignant tumor. Very
rarely, a lentigo maligna may arise in such a lesion of long duration.
In xeroderma pigmentosum, melanoma may arise in pre-existing
solar lentigo.