Lentigines—small, well-demarcated tan or brown macules often encircled by sun-damaged skin—can also appear on normal skin (A). These macules, which become more numerous with advancing age, usually appear in groups (B).1 Typical histologic findings include thickening of the epidermis and increased pigmentation of the basal layer. Melanocytes may increase in number but they do not form nests. Lentigines may evolve gradually over time or they can erupt suddenly. The pigment ranges from tan to brown to black; it may be homogeneous or variegated.
Patients sometimes request treatment for cosmetic reasons. Options include 20% to 50% trichloroacetic acid and cryotherapy (both of which may produce hypopigmentation that is usually transient) and topical products that contain hydroquinone or tretinoin.1
1. Ortonne JP, Pandya AG, Lui H, Hexsel D. Treatment of solar lentigines. J Am Acad Dermatol. 2006;54(5suppl 2):S262-S271.