Dermatology - diseases of the skin



Lentigo (lenticular spot or freckle, melanoma lentigo, lentigines, lentigo profesore, naevus incipiens, military naevus, non-specific pigmentation) – benign pigmented and dark yellowish brown in color, with a diameter of on average 1 to 2 cm, formed from melanocytes. Rarely degenerates into a malignant form of melanoma. The risk of malignancy (malignancy) increases with frequent trauma. Multiple lesions of the skin elements lentigo combine the concept – lentigos.

Lentigo characterized by a chronic course and a slow growth rate. The most commonly occurs in older people (60-70 years). Women with lentigines are more common than men. However, mortality from lentigo when malignancy is higher in males, as in this case, the tumor becomes more aggressive form.

Lentigines may occur on the face, sometimes on the neck, on the hands and legs. The first symptom of malignancy lentigo is the formation of small inconspicuous infiltration, which becomes inflamed and palpation is detected in the form of a nodule under the skin.

Malignant melanoma lentigo can give early metastasis limpiando and hematogenous, therefore, is a cause of high mortality from skin cancer (up to 75% of the total number of cases). Annually worldwide lentiginosa ill 92 000 people. In the last 30 years there has been an increasing incidence in the white population.

There are several types lentigo:

1. Senile (liver, senile spot) emerging from behind a senile (senile) of disorders of metabolism, resulting in excessive deposition of melanocytes in the skin.
2. Children and youth – occurs in the first decade of a child’s life and has no connection with the solar irradiation.
3. Solar – occurs under the influence of solar radiation.
4. Hereditary (disease Touraine, periorificial form) is transmitted over the dominant principle of inheritance and new elements lentigines occur throughout life.

Causes of lentigo

There are many factors that play a role in the occurrence of lentigo:
Causes of lentigo• Excessive exposure and sensitivity to ultraviolet radiation.
• Sunburn and prolonged exposure to the sun (especially in mountainous areas).
• Sunburn in childhood.
• Mutations in genes.
• Light skin (I or II), blonde hair, bright eye color. The degree of pigmentation of the skin depends on the type of melanin.
• Exposure to artificial radiation sources.
• The age and condition of the immune system.
• Genetic factors (Fonoti, heredity).
• Immunosuppression (recipients of donor organs and AIDS patients).
• Carriers of the human papilloma virus.
• The role of hormones (puberty, pregnancy and childbirth, as well as the adoption of hormonal contraceptives)

What disease can be mistaken for lentigo

Any increased pigmentation of the skin initially not a threat. But from time to time, is to consult a dermatologist. The early stage of the development of lentigines can be mistaken for:
Freckles – slightly brownish spots having a diameter of 3 mm on the face, shoulders and neck.
Birthmark – congenital cutaneous mark, which is usually darker than the rest of the skin. Depending on the color distinguish 3 types of stains: wine, salmon and red-dot (hemangioma)
Mole (nevus) – congenital benign tumor of the skin.
– Chloasma – hyperpigmentation of the skin area, due to the high content of melanocytes.

When to call the doctor

The main role in preventing malignancy (malignancy) lentigo is early diagnosis, which allows to detect melanoma at the stage, where full recovery. It is important to identify early symptoms, in time to consult a dermatologist or oncologist and prevent the degeneration of melanocytes.

First signs of malignancy lentigo:

1. The asymmetry of the shape.
2. Uneven border of the lesion.
3. Uneven color spots.
4. Diameter more than 6 mm.
5. Convexity and surface roughness.
6. The itching sensation.
7. Inflammation.

Late signs or metastases:

The 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 detailed examination of the deep structures of the skin by using dermatoscopy or biopsy. The doctor evaluates the thickness and depth of the tumor. Histopathological study is complemented by studies using monoclonal antibodies that would more accurately identify the type of cancer cells. To identify possible metastases, biopsy of the lymph nodes.

Treatment of lentigo

Treatment of benign forms of lentigo is no different from treating freckles or chloasma. After the consultation with an oncologist or dermatologist, you can apply techniques such as retinol peels, laser processing (grinding) of the skin, photoprotective UF filters, etc.

Any suspicious skin changes that indicate a melanoma, it needs to be removed completely.

Treatment of lentigo• Surgery is the only effective procedure for the treatment of melanoma Lentigo. The excised tissue is slightly wider affected area. Prophylactic removal is made without regional lymph nodes. In the case of metastases in regional lymph nodes is radical resection.
• Perfusion is a method of treatment of inoperable malignizirovannogo lentigines on the limbs. During the procedure stops the blood flow with the tourniquet and administered cytotoxic agents (melphalan, dacarbazine – DTIC), which inhibit tumor growth. Perfusion gives good results in cases of multiple recurrences or metastases.
• Radiation therapy – in some cases, it may be effective. It is used as after surgical treatment and in the case of inoperable tumors. Radiation therapy should be applied in large doses (500-600 R times a week), unlike radiation therapy of other tumors that involve smaller and more frequent doses.
• Chemo – therapy drugs (bleomycin, vincristine, lomustine). Suppresses the development of cancer cells.
• Treatment of metostazy – by the removal of isolated metastases in lymph nodes or distant organs (brain, lungs, liver).
• Glycosylated INF – treatment with human interferon, has no side effects. Used in combination with other drugs to treat metastatic disease.
• Gene therapy is a vaccination against the tumor.

The Effectiveness of treatment lentigo

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

The prognosis of malignant forms of lentigo adverse. Other forms of benign lentigines can be treated by cosmetic after consultation with a dermatologist or oncologist.

Prevention lentigo

• Avoid exposure to sunlight, especially in children, in combination with sun exposure and sunburn.
• It is advisable to choose a Sunny day to wear sunglasses, a hat with a wide brim, and avoid the sun C11.00 to 15.00.
• It is recommended that regular use of creams with sunscreen filters. Filters are substances that reflect or absorb UF radiation. Thus, they weaken 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 are more long-term sun exposure.

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