Enlarging brown spots:
 a misdiagnosed solar lentigo?

This patient presented for the evaluation of enlarging brown spots.
This patient presented for the evaluation of enlarging brown spots.

I was reviewing the September 2015 issue [Dermatologic Look-Alikes, "Enlarging brown spots"]. Immediately, I noticed a pinkish spot on the right medial clavicular region, which potentially could be a lichenoid keratosis, an actinic keratosis, a superficial basal cell carcinoma, a squamous cell carcinoma in situ, or the one diagnosis nobody wants to miss and is probably more unlikely, a melanotic melanoma. The point of why I am writing is that the "enlarging brown spot" most definitely appears to be a solar lentigo. I'm not sure if the pinkish lesion was treated, discussed, or potentially overlooked.

If the lesion was not addressed, the patient should return to have it re-evaluated to have it possibly treated or biopsied.—JUAN KOJIMA, PA-C, San Diego, Calif. (207-3)


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