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Updated: Oct 30 2016


  • Snapshot
    • An 8-year-old girl is embarrassed because she has dark spots all along her cheeks and arms. She spends a lot of time playing in the sun and thinks that the spots are darker after sun exposure. At her annual exam, her pediatrician assures her that her dark spots are harmless.
  • Introduction
    • Common, benign small brown macule that darkens with sunlight
    • Genetics
      • autosomal dominant inheritance pattern
    • Epidemiology
      • common in light-skinned individuals
    • Pathogenesis
      • normal number of melanocytes with ↑ melanin pigment
    • Also known as “freckles
  • Presentation
    • Symptoms
      • darkens with sun exposure
      • lightens without sun exposure
    • Physical exam
      • sharply defined brown macules
      • limited to face, arms, upper trunk
  • Evaluation
    • Diagnosis by clinical exam and history
  • Differential
    • Flat seborrheic keratosis
    • Pigmented actinic keratosis
  • Treatment
    • Sunscreen use and avoid sun exposure
  • Prognosis, Prevention, and Complications
    • Prognosis
      • most will fade by winter time
    • Prevention
      • sunscreen use and avoid sun exposure
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