Freckles and lentigenes are small pigmented macules that look similar but which may differ in their significance.


Clinical features of freckles (ephelides):

(1) autosomal dominant inheritance

(2) affected patients typically have red or blonde hair and blue eyes

(3) affected by sun exposure, usually most noticeable in sun-exposed skin

(4) tend to regress the elderly


Hereditary lentigenes:

(1) are not affected by sun-exposure and may be found in areas without sun exposure, including mucocutaneous orifices.

(2) They tend to be darker than freckles and to darken with age.

(3) develop during childhood and increase in number until puberty


Hereditary conditions with numerous lentigenes:

(1) LEOPARD syndrome

(2) Carney's complex

(3) Peutz-Jeghers syndrome

(4) centrofacial lentigenosis

(5) Laugier-Hunziker syndrome

(6) lentiginosis profusa


Acquired lentigenes:

(1) usually appear when the person is an adult

(2) often are related to sun exposure


Conditions with acquired lentigenes:

(1) solar lentigo

(2) Addison's disease


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