II. Epidemiology
- Common occurrence in light-skinned, red-haired patients
- Onset in childhood, after Sun Exposure
III. Signs
- Characteristics
- Light, tan or brown Macules, each 1-2 mm with sharp demarcation
- Darkens with Sun Exposure
- Vary in number from a few to hundreds of Freckles
- Distribution
- Face and nose more commonly affected
- Neck, chest, arms, legs are also affected
IV. Differential Diagnosis
- See Hyperpigmentation
-
Lentigo (juvenile Lentigines onset in childhood, or Solar Lentigines in older adults)
- Lentigo does not darken on sunlight exposure
-
Peutz-Jeghers Syndrome
- Pigmented lesions ("Freckles") on lips that crosses vermilion border
- Pigmented lesions are also found on the Buccal mucosa, periorbital face, hands and fingers
V. Management
- Skin Cancer Prevention
- Sun avoidance
- Sunscreen
- Frequent skin exam
- Cosmetic removal
- Typically not needed (lesions are asymptomatic and fade in winter)
- Same treatments used in Lentigo may be employed for Freckles
- Light Cryotherapy
- Hydroquinone
- Azelaic Acid
- Laser therapy