A cafe au lait patch is typically much larger and lighter brown than a small, dark brown or black lentigo simplex.
An intradermal nevus is a raised, dome-shaped papule, whereas a lentigo simplex is a completely flat macule.
These two can be clinically indistinguishable. A lentigo is a proliferation of melanocytes without nest formation, whereas a junctional nevus has nests of melanocytes at the dermal-epidermal junction.
Lentigo maligna is much larger, has irregular borders and colors, and occurs on sun-damaged skin, unlike a small, well-demarcated lentigo simplex.
Melanoma is distinguished from a simple lentigo by having irregular features (ABCDEs) and showing documented growth or change.
MIS is larger and more irregular than a simple lentigo and is confirmed on biopsy.
This is a café-au-lait patch with darker lentigines speckled within it, a different morphology.
This is a systemic syndrome where multiple lentigines are characteristically clustered on the lips and oral mucosa, associated with intestinal polyps.
A pigmented BCC has features of a carcinoma, such as a pearly border or surface telangiectasias, not seen in a lentigo.
A flat SK (solar lentigo) is similar, but a classic SK has a waxy, "stuck-on" appearance.
