Lentigo Solaris

A benign acquired hyperpigmented lesion caused by chronic ultraviolet (UV) exposure, characterized by well-demarcated brown to dark brown macules on sun-exposed skin.

Epidemiology

• Common in older adults >60 y.o (“age spots”, “liver spots”)

• Increases with cumulative sun exposure

• Occurs in all skin types, more visible in lighter skin

• No significant sex predilection

Aetiology & Pathogenesis

Etiology

• Chronic UV radiation (UVB and UVA)

• Photoaging

Pathogenesis

• Increased number of melanocytes in the basal layer

• Increased melanin production

• Elongation of rete ridges

• No cellular atypia (benign)

Clinical presentation

• Flat, well-circumscribed macules

• Color: light brown to dark brown

• Size: few millimeters to several centimeters

• Shape: round or oval

• Non-scaly, asymptomatic

• Persistent (do not fade in winter)

Common Sites

• Face

• Dorsal hands

• Forearms

• Shoulders

• Upper back

Investigations

Clinical Diagnosis

• Based on appearance and sun-exposed distribution

Dermoscopy

• Homogeneous brown pigmentation

• Fingerprint-like pattern

Biopsy (if atypical)

• Increased melanocytes

• Elongated rete ridges

• No dysplasia

Management

General Measures

• Sun protection (sunscreen, clothing)

• Regular skin surveillance

Cosmetic Treatment (Optional)