Perilesional vs. lesional skin changes in senile lentigo
Article first published online: 7 JUN 2004
Journal of Cutaneous Pathology
Volume 31, Issue 6, pages 441–447, July 2004
How to Cite
Cario-Andre, M., Lepreux, S., Pain, C., Nizard, C., Noblesse, E. and Taïeb, A. (2004), Perilesional vs. lesional skin changes in senile lentigo. Journal of Cutaneous Pathology, 31: 441–447. doi: 10.1111/j.0303-6987.2004.00210.x
- Issue published online: 7 JUN 2004
- Article first published online: 7 JUN 2004
- Accepted January 25, 2004
Background: Senile lentigo (SL) is a common component of photoaged skin. It is characterized by hyperpigmented macules which affect chronically irradiated skin mostly after 50 years of age. This study was undertaken to assess the basic morphology of SL on dorsum of hands.
Methods: A systematic comparison between lesional vs. perilesional skin using immunohistochemistry and electron microscopy was done to detect precursor lesions of SL and to determine whether melanocytes or keratinocytes were first affected in the evolution of lesions.
Results: In 12 cases studied, the main findings show that clusters of perilesional keratinocytes accumulate melanin in large melanosomial complexes, and that melanocytes counts are increased respective to total length of section in lesional skin, but the increment is probably due to the development of characteristic epidermal rete ridges. Melanocytes had overall a normal ultrastructure, with mostly quiescent features in perilesional skin and melanosomial transport seeming more active in lesional skin.
Conclusions: Our data indicate that SL may represent a loss of epidermal melanin unit homeostasis due to chronic irradiation, where keratinocytic changes predominate over melanocytic changes. We hypothesize that abnormal pigment retention in keratinocytes is the primary defect in SL, which may partly explain the therapeutic effect of retinoids.