Pigmented lesions
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Overview
Pigmented lesions are common and in many cases benign. Though many are benign, it is important for the physician to rule out melignancy to ensure it is not dangerous. They will do this with a biopsy to determine the diagnosis.
Classification
The three most common types are:
Causes
Causes in Alphabetical Order[1][2]
- Benign mole
- Blue Nevus
- Cafe au lait macule
- Dermatofibroma
- Dysplastic nevus
- Freckle
- Malignant Melanoma
- Seborrheic Keratosis
- Solar lentigo
Diagnosis
History and Symptoms
- Note: changes in skin appearance, lesion size, lesion length, any bleeding or irritation
Other Diagnostic Studies
Biopsy
- Shave biopsy: tests for actinic keratosis & seborrheic keratoses
- Deep scoop shave biopsy, excisional biopsy, punch biopsy: tests for dysplastic nevus and melanoma
Treatment
Medical Therapy
- Solar lentigines & Freckles: reassurance, lasers or pulse light
Surgery and Device Based Therapy
- Keratoses: topical cryotherapy
Primary Prevention
- Sunscreen
- Annual full skin exams