Also defined as “simplex”, solar lentigines are light to dark brown areas of flat skin with regular borders. They occur mainly in areas exposed to the sun (face and hands), and are caused by an accumulation of melanocytes. They are often associated with other signs of cutaneous aging, such as elastosis and dilation of small blood vessels. The treatment of choice for these lesions (once a definite benign diagnosis has been made) is the Q-switched laser. The use of a 532nm wavelength or, in the case of older lesions, the use of a 694nm wavelength (ruby laser) causes fragmentation of the pigment; it is then removed, both through transepidermal elimination and phagocytosis by mastocyte cells. These treatments affect only the pigmented lesion and do not cause rejuvenation of surrounding tissue due to thermal transfer. When solar lentigines are numerous, associated with fine telangiectasias and there are no lines or wrinkles or other more severe signs of cutaneous aging, some treatment with IPL (which liberates heat that stimulates collagen production) followed by treatment with Q-switched laser is the preferred method.
Solar lentigo (liver spots)
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