From the Guidelines
A lentiginous compound nevus is a benign skin growth that combines features of both lentigo and compound nevus, characterized by a proliferation of melanocytes at the junction between the epidermis and dermis, as well as within the dermis itself. These growths appear as brown to black, flat to slightly raised spots on the skin with irregular borders, and are generally harmless unless they undergo changes in appearance, which could indicate malignant transformation 1. Key characteristics of lentiginous compound nevi include:
- Brown to black color
- Flat to slightly raised appearance
- Irregular borders
- Location in sun-exposed areas
- Potential to increase in number with age or sun exposure It is essential to monitor these lesions for any changes in size, shape, color, or symptoms such as bleeding, itching, or pain, as these could be indicative of malignant transformation, and evaluation by a dermatologist is recommended in such cases 1. The diagnosis of suspicious pigmented lesions, including lentiginous compound nevi, can be enhanced by dermoscopy by an experienced physician, which improves diagnostic accuracy [II, B] 1. Full body imaging with high-resolution pictures and automated videodermoscopy systems can also aid in early detection and follow-up of these lesions 1. However, the use of patient-operated diagnostic devices without medical supervision is not recommended at present 1. In clinical practice, it is crucial to apply the 'ugly duckling' concept and the 'ABCD' rule (Asymmetry, Border irregularities, Colour heterogeneity, Dynamics) to identify suspicious pigmented lesions, including lentiginous compound nevi 1.
From the Research
Definition of Lentiginous Compound Nevus
- A lentiginous compound nevus is a type of melanocytic nevus that exhibits a lentiginous pattern, characterized by a proliferation of melanocytes at the dermoepidermal junction, both as single cells and as small nests, with areas of confluent growth 2.
- It is a benign melanocytic lesion that can be distinguished from lentiginous melanoma, a malignant condition that can arise in sun-damaged skin 2, 3.
Histopathological Features
- The histopathological features of a lentiginous compound nevus include a lentiginous proliferation of melanocytes at the dermoepidermal junction, with nests of melanocytes involving the dermoepidermal junction at the tips of the papillae 4.
- The lesion may exhibit dermal fibrosis and cytological atypia, but pagetoid spread of melanocytes is not prominent in hematoxylin- and eosin-stained sections 2.
Differential Diagnosis
- The differential diagnosis of a lentiginous compound nevus includes lentigo maligna, atypical lentiginous junctional nevus, and melanoma in situ 5, 2, 3.
- It is essential to consider the clinical and pathological features of the lesion, as well as the patient's age and sun exposure history, to make an accurate diagnosis 5, 3.