Ephelis

Ephelis, commonly known as freckle, is a benign flat pigmented skin lesion. It is in the differential diagnosis of pigmented skin lesions.

General

• Benign.
• Increases with ultraviolet light exposure.

Gross

• Flat pigmented lesions.
• Typically in sun exposed areas.

Image:

• Freckles (WC).

Microscopic

Features:

• Basal pigmentation of keratinocytes.
• Normal numbers of melanocytes.
• Normal rete ridges.

DDx:

• Solar lentigo - long rete ridges and solar damage.
• Simple lentigo - long rete ridges.
• Café-au-lait spots.

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FOREARM, RIGHT, PUNCH BIOPSY:
- SKIN WITH INCREASED BASAL PIGMENTATION WITHOUT INCREASED NUMBERS OF 
  MELANOCYTES -- CONSISTENT WITH EPHELIS (FRECKLE).

Micro

The sections show hair-bearing skin with light basal hyperpigmentation. Melanocytes are present in normal numbers. The rete ridges are of normal length. No melanocytic nests are identified. There is no keratinocyte atypia and no parakeratosis. No significant inflammation is identified.

See also

• Dermatopathology.
• Melanocytic lesions.
• Malignant melanoma.