Young Female with Multiple Pigmented Macules on Face

Abstract

A 20 years old female presented with multiple small brown pigmented macules over cheek, nose and upper eyelids without any systemic complaints. There was no history of spontaneous resolution of lesions. Based on these clinical information diagnosis of lentigo was made. Lentigines are small hyperpigmented well demarcated macules resulting due to increased number of melanocytes. Based on cause of lentigo formation they can be classified as lentigo simplex, solar lentigo, PUVA lentigo, radiation lentigo and sometimes they are associated with genetic factors. Lentigo simplex is the most common lentigo and chronic sun exposure is most important causing factor but they don’t disappear on avoidance of sun exposure. Common differential diagnoses are freckles, nevus spilus and flat seborrhoeic keratosis. Usually, diagnosis is made on clinical grounds. Histopathology of lentigo shows increased pigmentation of basal layer with slight increase in number of non-atypical melanocytes. Dermoscopy shows scalloped borders, pseudonetwork and structureless areas. Lentigo simplex usually doesn’t require any active treatment. Avoidance of causative factor may reduce development of new lesions. For cosmetic concern depigmenting agents, chemical peels, Q-switch Nd:Yag laser can be used with variable success.