Speckled Lentiginous Nevus Clinical Presentation

Updated: Apr 07, 2017
  • Author: Rossitza Lazova, MD; Chief Editor: Dirk M Elston, MD  more...
  • Print
Presentation

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. It has also been reported in the oral cavity. [20]

Next:

Physical Examination

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.

See the image below.

A large unilateral speckled lentiginous nevus that A 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.

See the image below.

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.

Previous
Next:

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.

Previous
Next:

Complications

Malignant melanoma may develop within speckled lentiginous nevus. Predictors of the risk of malignant transformation of a speckled lentiginous nevus have yet to be determined. The surface area, the number of nevi within the speckled lentiginous nevus, and/or the presence of cytologic atypia may be factors that affect the potential for malignant transformation of a speckled lentiginous nevus.

Previous