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Cardiovascular

Abdominal pain in kids

Abnormal/Dysfunctional Uterine Bleeding (AUB/DUB)

Acanthosis Nigricans

Actinic Cheilitis

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CVD Risk Assessment

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Dermal melanocystosis (mongolian spot)

Developmental Dysplasia of the Hip (DDH)

Diabetes Insipidus (DI) vs Primary Polydipsia

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Dizziness / syncope

Duchenne muscular dystrophy

Dupuytrens / trigger finger

Dyspnoea (Shortness of Breath)

Ink Spot Lentigo

Presentation

Solitary, dark macules with irregular borders
Occurs in sun-exposed areas

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Management

No treatment needed, unless for cosmetic reasons
Monitor for melanoma-like changes

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Types of Lentigo

Type	Description	Location	Appearance	Associated Conditions
Lentigo Simplex	Common in childhood, may fade. Precursor to junctional naevus.	Trunk, limbs	Small brown macule/plaque, round/oval, smooth/jagged edges, dry surface.	None
Solar Lentigo	From chronic sun exposure, may resemble seborrhoeic keratosis.	Hands, face, lower legs, shoulders	Yellow/light/dark brown macule or thin plaque, moth-eaten outline, dry surface.	Seborrhoeic keratosis, lichenoid keratosis
Ink Spot Lentigo	Follows sunburn, fewer than solar lentigines.	Sun-exposed areas, trunk	Dark brown/black, irregular "ink spot" macule.	None
PUVA Lentigo	Follows PUVA photochemotherapy.	PUVA-exposed areas	Dark brown/black, irregular macule, similar to ink spot lentigo.	PUVA therapy
Tanning Bed Lentigo	From indoor tanning.	Tanning bed-exposed areas	Brown macule.	Indoor tanning
Radiation Lentigo	After irradiation, linked to late-stage radiation dermatitis.	Irradiated site	Dark brown macule, may have atrophy, fibrosis, telangiectasias.	Radiation dermatitis
Melanotic Macule	Found on mucosal surfaces.	Lips, vulva, anus	Light/dark brown macule.	Mucosal melanosis
Generalised Lentigines	Appear in childhood, merge into patches. Not syndromic.	Exposed/covered sites	Small brown macules merging into patches.	Lentigines profusa
Agminated Lentigines	Segmental lentigines with sharp midline demarcation.	Segmental area	Clustered lentigines.	Neurological/developmental abnormalities
Patterned Lentigines	Inherited, common in African ethnicity.	Face, lips, buttocks, palms, soles	Brown macules forming distinct patterns.	Centrofacial neurodysraphic lentiginosis, intellectual disability
Lentiginosis Syndromes	Syndromic, autosomal dominant or sporadic.	Widespread, present from birth/early childhood	Diffuse lentigines.	LEOPARD/Noonan, Peutz-Jeghers, Laugier-Hunziker, Xeroderma pigmentosum, Cowden disease, Bannayan-Zonana syndrome, etc

Ink Spot Lentigo

Presentation

Solitary, dark macules with irregular, “ink spot” borders
Typically appears in sun-exposed areas (commonly on the trunk)
Generally asymptomatic, discovered incidentally
Can appear after intense sun exposure or sunburn; fewer in number than solar lentigines

Management

No specific treatment is necessary unless for cosmetic reasons.
Monitoring is prudent if there are any features suspicious for melanoma-like changes (e.g., rapid growth, colour change, irregular borders).
Consider dermatological opinion if uncertain about differentiation from atypical naevus or melanoma.

Types of Lentigo (Overview)

Type	Description	Location	Appearance	Associated Conditions
Lentigo Simplex	Common from childhood; can fade over time; precursor to junctional naevus.	Trunk, limbs	Small brown macule/plaque, round/oval, smooth or jagged edges, dry surface.	None
Solar Lentigo	From chronic sun exposure; can resemble seborrhoeic keratosis.	Hands, face, lower legs, shoulders	Yellow/light-brown to dark-brown macule or thin plaque, “moth-eaten” border, dry surface.	Seborrhoeic keratosis, lichenoid keratosis
Ink Spot Lentigo	Follows sunburn, fewer than solar lentigines.	Sun-exposed areas, trunk	Dark brown/black “ink spot” macule, irregular border.	None
PUVA Lentigo	From photochemotherapy (psoralen + UVA).	PUVA-exposed areas	Dark brown/black irregular macule, similar to ink spot lentigo.	PUVA therapy
Tanning Bed Lentigo	Associated with indoor tanning.	Tanning bed-exposed areas	Brown macule.	Indoor tanning
Radiation Lentigo	After radiation therapy, can accompany late radiation dermatitis.	Irradiated site	Dark brown macule, may have atrophy, fibrosis, telangiectasia in the area of prior radiation.	Radiation dermatitis
Melanotic Macule	Found on mucosal surfaces.	Lips, vulva, anus	Light/dark brown macule.	Mucosal melanosis
Generalised Lentigines	Appear in childhood, may merge into patches, usually non-syndromic.	Exposed/covered sites	Numerous small brown macules merging into larger patches.	Lentigines profusa
Agminated Lentigines	Segmental lentigines with a sharp midline demarcation.	Segmental area	Clustered lentigines in one region.	Possible neurological/developmental abnormalities
Patterned Lentigines	Inherited forms, often in African ethnicity.	Face, lips, buttocks, palms, soles	Brown macules forming distinct patterns.	Can occur in syndromes with neurodysraphic features, intellectual disability
Lentiginosis Syndromes	Syndromic, autosomal dominant or sporadic.	Widespread, from birth/early childhood	Diffuse lentigines.	LEOPARD/Noonan syndrome, Peutz-Jeghers, Laugier-Hunziker, Xeroderma pigmentosum, Cowden disease, Bannayan-Zonana syndrome, etc

Notes

Ink Spot Lentigo is typically benign but should be differentiated from atypical naevi or melanoma if suspicious changes occur.
Sun protection (broad-spectrum sunscreen, protective clothing) is advised to prevent new lesions.
If in doubt, consider dermatologist evaluation; occasionally, dermatoscopy or biopsy may be needed.

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