Ephelis and lentigines

• Ephelis aka brown spots and freckles:

  • Arise on the mid face from early childhood onwards
  • Usually less than 3mm
  • Fade during the winter months
  • Get less noticeable with age
  • No treatment required - advice patients about sun protection
• Lentigines:

  • Brown flat lesions with a clearly defined edge
  • Most common type = solar lentigines - arise in middle age and result from sun damage
  • Most often found on the face and hands
  • Larger and border sharply defined compared to freckles
  • Can have a dry or slightly scaly surface
  • Persist during winter (may fade a bit)
  • Colour is uniform across the lesion
  • Need to distinguish them from early melanoma e.g. lentigo maligna (non-uniform colour)
• Risk factors:

  • Sun exposure
  • Fitzpatrick I+II - lentigines also seen in people with darker skin
• Management:

  • Prevention with sun protection
  • Variety of treatments to remove/reduce appearance e.g. creams containing hydroquinone or antioxidants, chemical peels, cryotherapy, laser