Clinical Application Questions

A 44-year-old man requests evaluation of an irritated brown lesion on his left shoulder. Evaluation reveals a typical 5-mm "stuck on" seborrheic keratosis. He also has multiple lentigines of various sizes in a solar distribution over his upper back, shoulders, and upper chest. An asymmetric multicolored 4 x 8 mm lesion is present on his left anterior shoulder. It has a notched margin and stands out from the other lesions.

1. Should the multicolored lesion be biopsied?

2. What are the primary lesions that you would expect to find in solar lentigines?

3. What are the secondary lesions that you would expect to find in solar lentigines?

4. What should you tell the patient about the solar lentigines?

5. Is there any relationship between lentigines and melanoma?

6. How are solar lentigines treated?

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