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Speckled Lentiginous Nevus Differential Diagnoses

  • Author: Rossitza Lazova, MD; Chief Editor: Dirk M Elston, MD  more...
Updated: Oct 19, 2015

Diagnostic Considerations

In its earliest stage, speckled lentiginous nevus can be confused with a café au lait macule. In agminated melanocytic nevi, the background skin is not hyperpigmented, unlike that in speckled lentiginous nevus. In partial unilateral lentiginosis, multiple lentigines are grouped together on skin that has a normal color.

Differential Diagnoses

Contributor Information and Disclosures

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, International Society of Dermatopathology

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

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

Disclosure: Nothing to disclose.

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

Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, Noah Worcester Dermatological Society, Pennsylvania Academy of Dermatology, American Academy of Dermatology, Phi Beta Kappa

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

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

Disclosure: Nothing to disclose.


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

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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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