Lentigo maligna, also known as Hutchinson’s freckle, is a type of malignant melanoma (skin cancer) that appears as flat patches of skin on sun-exposed areas. It is one of the four major types of melanoma and has the most favorable prognosis because there is less risk of it spreading to other areas of the body.

Lentigines are observed worldwide and the incidence depends on the type of lesion. In the United States solar lentigines are observed in 90 percent of Caucasian population older than 60 years and in 20 percent of Caucasian younger than 35 years. The most common form found is lentigo benigna or simplex, but it has not to be determined.

Lentigines are more common in men than in women and the patches can appear in both children and adults, whom are more likely to acquire these lesions due to chronic sun exposures, that however, children to whom lentigo is genetically associated with lesions such as those of Peutz-Jeghers syndrome.

Symptoms of lentigo maligna

Symptoms of lentigo maligna are lesions on the skin that appear tan to brown and occur on the head, neck and back of the hands. They are typically two to six centimeters in length and are irregularly shaped with darker spots.

Treatment of lentigo maligna

The treatment of choice is surgical excision if the lesion is small. Retinoids decrease the cohesiveness of abnormal hyper-proliferative keratinocytes and may reduce the potential for malignant degeneration and consequentlyreduce the risk of skin cancer in patients who have undergone renal transplantation. Radiation therapy is the treatment of choice for elderly patients with an extensive lesion. These lesions should not be treated with liquid nitrogen cryotherapy, as a rule, because the dysplastic melanocytes go down hair follicles and deep recurrence post-cryotherapy is common.

Self-care tips

surgical excision patients diagnosed with lentigo maligna can be improved through early detection, promoting patient awareness and self-examination, and encouraging regular physical examinations of patients who are at increased risk of the disease. Sunscreen use and avoiding intense, intermittent sun exposure may also be recommended.

Prevention

Prevention should be focused to reduce morbidity and prevent complications. It is always advisable to use an application of sunscreen to help decrease the rate of appearance and the darkening of solar lentigines. Limiting the sun exposure and the avoidance of sun tanning, the same as the use of artificial sources of UV light such as tanning beds, may help to prevent this condition.