Lentigo - Causes, symptoms and treatment. MF.

Causes of
Causes of
What causes can be confused with Lentigo and when it is necessary to see a doctor
Lentigo treatment
Forecast
Lentigo prevention

Lentigo( lenticular spotting or freckle, melanoma lentigo, lentiginosis, lentigo, obstructive nevus, melacytic nevus, nonspecific pigmentation) - benignpigmented spot of a yellowish and dark brown color, with an average diameter of 1-2 cm, formed from melanocytes. It is extremely rare to degenerate into a malignant form of melanoma. The risk of malignancy( malignancy) increases with frequent trauma. Multiple lesions of the skin with Lentigo elements are united in the concept - lentigious.

Lentigo

Lentigo is characterized by a chronic course and slow growth rate. It is most common in the elderly( 60-70 years).Women with lentigo are more common than men. However, mortality from lentigo in malignancy is higher in males, since in this case the tumor acquires a more aggressive form.

Lentigo can appear on the face, sometimes on the neck, on the surface of the hands and legs. The first symptom of malignization of lentigo is the formation of a small unobtrusive infiltrate, which inflames and when palpation is detected as a nodule under the skin.

Malignant melanoma of lentigo can give early metastasis of lymphogenically and hematogenically, and is therefore the cause of high mortality from skin cancer( up to 75% of the total number of cases).Every year around the world, 92,000 people fall ill with lentigyosis. Over the past 30 years, there has been an increase in the incidence among the white population.

There are several types of lentigo:

1. The senile( hepatic, senile spot) - appears due to senile( senile) metabolic disorders, resulting in excessive deposition of melanocytes in the skin.
2. Child and youth - occurs in the first decade of a child's life and has no connection with solar radiation.
3. Solar - occurs under the influence of solar radiation.
4. Hereditary( Turen's disease, periori formal form) - is transmitted by the dominant principle of inheritance and new elements of lentigo arise throughout life.

Reasons for Lentigo

There are many factors that play a role in the appearance of Lentigo:
• Excessive exposure and sensitivity to ultraviolet radiation.
• Sunburn and prolonged exposure to the sun( especially in mountainous areas).
• Sunburns in childhood.
• Mutations in the genes.
• Light skin( I or II), blonde hair, bright eye color. The degree of skin pigmentation depends on the type of melanin.
• Effects of artificial radiation sources.
• Age and condition of the immune system.
• Genetic factors( phonotype, heredity).
• Immunosuppression( recipients of donor organs and AIDS patients).
• Carrier of human papillomavirus.
• The role of hormones( during puberty, pregnancy and childbirth, and the acceptance of hormonal contraceptives)

What diseases can be confused with Lentigo

Any increase in skin pigmentation is not inherently dangerous. But from time to time, it is worth consulting with a dermatologist. The early stage of development of lentigo can be mistaken for:
- Freckles - slightly brownish spots, having a diameter of 3 mm on the skin of the face, shoulders and neck.
- Birthmark is a congenital skin mark, which is usually darker than the rest of the skin. Depending on the color, there are 3 types of spots: wine, salmon and red-dot( hemangioma)
- Birthmark( nevus) - congenital benign skin tumor.
- Chloasma - hyperpigmentation of the skin area, due to the increased content of melanocytes in it.

When to consult a doctor

Early detection is playing a major role in preventing lentigo malignancy, which makes it possible to detect melanoma at the stage when complete cure is possible. It is very important to identify early symptoms in order to reach a dermatologist or oncologist on time and prevent the degeneration of melanocytes.

First signs of lentigo malignancy:

1. Form asymmetry.
2. Uneven border of defeat.
3. Uneven color of the spot.
4. The diameter is more than 6 mm.
5. Convexity and surface roughness.
6. Itching sensation.
7. Inflammation.

Late symptoms or metastases:

Inflammatory process in the skin or in the immediate vicinity of the tumor( intradermally or subcutaneously along the lymphatic system).

The diagnosis is confirmed by a complete examination of the deep structures of the skin with dermatoscopy or biopsy. The doctor evaluates the thickness and depth of the tumor. Histopathological research is complemented by studies using monoclonal antibodies to more accurately determine the type of cancer cells. To detect possible metastases, a lymph node biopsy is performed.

Lentigo treatment

Treatment of benign forms of lentigo does not differ from treatment of freckles or chloasma. After consultation with an oncologist or dermatologist, you can apply methods such as retinol peeling, laser processing( polishing) of the skin, photoprotection with UF filters, etc.

Any suspicious skin changes that indicate melanoma should be removed completely.

• Surgery is the only effective treatment for Lentigo melanoma. The tissue is excised slightly wider than the affected area. Prophylactic removal is performed without regional lymph nodes. In the case of metastases in regional lymph nodes, their radical resection is performed.
• Perfusion is a method of treating inoperable, malignant lentigo on the limbs. During the procedure, blood flow stops using a tourniquet and cytotoxic agents( melphalan, dacarbazine - DTIC) are introduced, which inhibit the growth of the tumor. Perfusion gives good results in cases of several relapses or metastases.
• Radiation therapy - in some cases can be effective. It is used, both after surgical treatment, and in the case of inoperable tumors. Radiation therapy should be used in large doses( 500-600 R times a week), in contrast to radiation therapy of other tumors, when smaller and more frequent doses are used.
• Chemotherapy - therapy with drugs( bleomycin, vincristine, lomustine).It suppresses the different stages of development of cancer cells.
• Treatment of metostases - by removing isolated metastases in lymph nodes or distant organs( brain, lungs, liver).
• Glycosylated INF - treatment with human interferon, no side effects. Used in combination with other drugs to treat metastatic disease.
• Gene therapy is a vaccination against a tumor. The gene of class I MHC is injected.

Forecast

An important indicator determining the forecast of malignant lentigo is the mitotic index. It has such parameters: the depth of invasion( penetration), the thickness of the changes, which allows to assess the risk of malignancy, metastasis and survival.

Prognosis of malignant lentigo form is unfavorable. The remaining forms of benign lentigo can be treated cosmetic by consulting a dermatologist or oncologist.

Prevention of Lentigo

• Avoid exposure to sunlight, especially in children, combined with exposure to sun and sun.
• It is advisable to wear sunglasses, hats with wide margins on sunny days and avoid appearing in the sun from 11.00 to 15.00.
• Regular use of creams with sunscreen filters is recommended. Filters are substances that reflect or absorb UF radiation. Thus, they reduce the harmful effects of the sun.

Remember, the use of filters does not completely prevent skin damage! Often, when using the cream people feel a false sense of security and stay longer in the sun for a longer time.

Doctor cosmetologist Kondratenko NA