Lentigo simplex

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Lentigo simplex
Diagnosis in short

Simple lentigo. H&E stain. (WC)

Synonyms simple lentigo

LM melanocytes in epidermis only - hyperpigmentation; no melanocytic nests; +/-mild/moderate elongation of the rete ridges
LM DDx solar lentigo, ephelis (freckle), melanotic macule, lentiginous nevus, early seborrheic keratosis
Site skin

Clinical history usu. older than 40 years
Prevalence common
Prognosis benign

Lentigo simplex is a common benign melanocytic lesion.

It is also known as simple lentigo.[1]

General

Fits into the larger category of lentiginous melanocytic proliferations - these include:[3]

Associated syndromes:[4]

Gross

  • Small flat pigmented lesion.[5]

DDx - clinical:

Microscopic

Features:[5]

  • Melanocytes in epidermis only.
    • Melanocytes basally located (normal location) with hyperpigmentation.
  • No melanocytic nests.
  • +/-Mild/moderate elongation of the rete ridges.[6]

DDx:[7]

Images

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Left Hand Lesion, Radial, Biopsy:
     - Simple lentigo/early seborrheic keratosis.

Block letters

SKIN LESION, LEFT ABDOMEN, BIOPSY:
- SIMPLE LENTIGO, COMPLETELY EXCISED IN THE PLANE OF SECTION.
SKIN LESION, LEFT ABDOMEN, BIOPSY:
- BENIGN SIMPLE LENTIGO.

Micro

The sections show skin with increased numbers of small pigmented melanocytes at the dermal-epidermal junction. The rete ridges are mildly elongated. No solar damage is apparent. No dermal melanocytes are identified. No melanocytic nests are identified. No nuclear atypia is apparent.

See also

References

  1. URL: http://www.dermnetnz.org/lesions/lentigo-simplex.html. Accessed on: 27 March 2013.
  2. Sahin, MT.; Oztürkcan, S.; Ermertcan, AT.; Güneş, AT. (Nov 2004). "A comparison of dermoscopic features among lentigo senilis/initial seborrheic keratosis, seborrheic keratosis, lentigo maligna and lentigo maligna melanoma on the face.". J Dermatol 31 (11): 884-9. PMID 15729860.
  3. Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 438. ISBN 978-0443066542.
  4. 4.0 4.1 URL: http://dermaamin.com/site/histopathology-of-the-skin/64-l/1852-lentigo-simplex-.html. Accessed on: 17 December 2012.
  5. 5.0 5.1 Humphrey, Peter A; Dehner, Louis P; Pfeifer, John D (2008). The Washington Manual of Surgical Pathology (1st ed.). Lippincott Williams & Wilkins. pp. 498. ISBN 978-0781765275.
  6. 6.0 6.1 Hafner, C.; Stoehr, R.; van Oers, JM.; Zwarthoff, EC.; Hofstaedter, F.; Klein, C.; Landthaler, M.; Hartmann, A. et al. (Nov 2009). "The absence of BRAF, FGFR3, and PIK3CA mutations differentiates lentigo simplex from melanocytic nevus and solar lentigo.". J Invest Dermatol 129 (11): 2730-5. doi:10.1038/jid.2009.146. PMID 19536147.
  7. 7.0 7.1 URL: http://www.humpath.com/?lentigo-simplex. Accessed on: 17 December 2012.