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Ink spot lentigo

Ink spot lentigo

Ink spot lentigo, also known as reticulated black solar lentigo, is a variant of solar lentigo characterized by very dark color and a beaded or wiry, markedly irregular outline. The condition was first described by Bolognia in 1992.

Epidemiology

The exact prevalence is not known. Suffice to say, it is an uncommon condition and the literature on this condition is limited to case reports. The prevalence is more common in fair-skinned individuals. The peak age of onset is between 30 and 40 years. The condition is more common in males.

Ink spot lentigo

  • Also known as reticulated lentigo
  • Few in number compared to solar lentigines
  • Follows sunburn in very fair skinned individuals
  • Dark brown to black irregular ink spot-like macule

Differential diagnosis.

Because of its dark color and irregular border, an ink spot lentigo has to be differentiated from a melanoma. In general, an ink spot lentigo is relatively symmetrical, macular, smaller, and stable in size as compared to a melanoma. A history of rapid increase in size, shape, and color of a preexisting or new nevus is suggestive of a melanoma. Other differential diagnoses include dysplastic nevus, solar lentigo, ephelide (freckle), and flat seborrheic keratosis.

Treatment

An ink spot lentigo can be aesthetically bothersome. This is particularly true if the lesion is in an exposed area.

The condition is benign and asymptomatic. As such, treatment is primarily for cosmesis. Treatment options include most commonly excision and, less often, laser surgery or intense pulsed light.

Sun avoidance during hours of peak ultraviolet intensity (11 AM to 4 PM) and the use of broad-spectrum sunscreens and protective clothing when outdoors may help to prevent appearance of a new lesion and worsening of the existing lesion.

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