Speckled Lentiginous Nevus Clinical Presentation

  • Author: Rossitza Lazova, MD; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Aug 17, 2011
 

History

  • Patients may complain of hyperpigmented or multicolored skin lesions, with colors most often including shades of tan, brown, and black.
  • The lesions are present at birth or noted during the individual's first years of life.
  • Patients may be aware of an increase in the size of the lesions or changes in color over time.
  • Skin distribution varies, with the trunk being the most common site of occurrence.
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Physical

  • A variable number of black, brown, or red-brown macules and papules are seen within a patch of tan-to-brown hyperpigmentation.
  • The background pigmented macule or patch is usually 3-6 cm in diameter, but the diameter may vary from 1 cm to more than 60 cm. A large unilateral speckled lentiginous nevus thatA large unilateral speckled lentiginous nevus that contains numerous small dark macules.
  • The lesions are usually oval, but they can be linear. Some follow the lines of Blaschko or have a sharp demarcation at the midline. An extensive amount of body surface area may be involved. Extensive speckled lentiginous nevus. Extensive speckled lentiginous nevus.
  • The macules (speckles) and papules lying within the background patch range from lentigines to junctional, compound, or dermal nevi.
    • Spitz nevi and blue nevi may also occur.
    • The speckles range from 1-9 mm; most commonly, they are 2-3 mm in diameter.
    • To the author's knowledge, deep penetrating nevus occurring within a speckled lentiginous nevus has not been reported.
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Causes

  • Speckled lentiginous nevi may represent a defect in the melanoblasts that populate a localized area of the skin.
  • Genetic and environmental factors may also play a role in their occurrence.
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Proceed to Differential Diagnoses
 
 
Contributor Information and Disclosures
Author

Rossitza Lazova, MD  Associate Professor of Dermatology and Pathology, Director of Dermatopathology Residency and Fellowship Program, Yale University School of Medicine; Consulting Pathologist/Dermatopathologist, Veterans Affairs Medical Center, West Haven, Connecticut

Rossitza Lazova, MD is a member of the following medical societies: American Academy of Dermatology, American Society of Dermatopathology, and International Society of Dermatopathology

Disclosure: Nothing to disclose.

Specialty Editor Board

Michelle Pelle, MD  Clinical Assistant Professor, Division of Dermatology, Department of Medicine, University of California at San Diego

Michelle Pelle, MD is a member of the following medical societies: American Academy of Dermatology, California Medical Association, Medical Dermatology Society, and Pennsylvania Medical Society

Disclosure: Nothing to disclose.

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Christen M Mowad, MD  Associate Professor, Department of Dermatology, Geisinger Medical Center

Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Ackerman Academy of Dermatopathology, New York

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Acknowledgments

The author would like to thank Dr. Jean Bolognia for generously providing the clinical photos.

References

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A large unilateral speckled lentiginous nevus that contains numerous small dark macules.
Extensive speckled lentiginous nevus.
Prominent basal layer pigmentation similar to that seen in lentigo simplex (hematoxylin-eosin stain, original magnification X200).
Elongated rete ridges and lentiginous proliferation of melanocytes at the dermal-epidermal junction (hematoxylin-eosin stain, original magnification X200).
Junctional melanocytic nevus composed of small nests of melanocytes and lentiginous melanocytic proliferation at the dermal-epidermal junction (hematoxylin-eosin stain, original magnification X100).
Compound melanocytic nevus with nests of uniform melanocytes in the epidermis and the dermis (hematoxylin-eosin stain, original magnification X200).
 
 
 
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