Abstract

Solar lentigo, benign lesions which mostly appear on chronically, sun-exposed surfaces, are associated with ageing. Patients are increasingly requesting a more uniform skin texture, especially for hands. Treatment options include dermoabrasion, intense pulsed light, cryotherapy, peelings, and laser therapy. Topical compounds can be employed, in alternative or associated with dermatologic procedures. The current study was designed to evaluate solar lentigo hyperpigmentation, skin architecture and clinician and patient assessments comparing a dermocosmetic lightening product (active) with a moisturizing product (control) according to clinical, digital and subjective analyses in 72 lesions over 12-month follow up period. Statistically significant differences were observed between the lesions treated with the active compared to the control in terms of papillary brightness (p = 0.03) and contrast (p = 0.03), and in the limitation of dermal-epidermal junction destructuring (p = 0.03) according to dermal-epidermal junction destructuring score at Reflectance Confocal Microscopy. Luminance (p = 0.04) and redness (p = 0.03) were improved at color analysis, and physician and patient evaluations favored the active in efficacy and patient satisfaction investigations. The dermocosmetic lightening product utilized in the current study proved to be more effective, according to clinical, digital and subjective analyses in reducing lesion hyperpigmentation, stabilizing the lesion skin architecture and increasing patient satisfaction compared to the control in a cohort of 36 subjects, over a 12-month period. Beside demonstrating the efficacy of this topical lightening product, we propose a “destructuring score”, which improves the robustness of solar lentigo’s evaluation, and can be used in future studies to standardize the quantitative comparisons of different treatment options.

Highlights

  • Solar lentigo lesions are a widespread aesthetic and social concern, as they are associated with ageing

  • The most striking features of solar lentigo lesions using Reflectance Confocal Microscopy (RCM) are the polycyclic papillary contours at the dermal-epidermal junction (DEJ) and cord-like structures corresponding to the elongated rete ridges seen in histopathological analysis [4,5]

  • Various options are available for the removal of solar lentigines, such as lasers (CO2, Q-Switched Nd-YAG, Ruby), intense pulsed light, cryotherapy and topical bleaching actives [6,23,24,25,26,27,28,29,30,31,32,33,34]

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Summary

Introduction

Solar lentigo lesions are a widespread aesthetic and social concern, as they are associated with ageing. Solar lentigo lesions are benign and mostly appear on chronically, sun-exposed surfaces (face and scalp, dorsum of the hands, neckline and upper back), and are frequently present among the elderly population. Solar lentigo lesions are small, light to dark brown, flat and are usually smooth. At dermoscopy they appear as a faint to dark brown reticular pattern (fingerprinting) or a homogeneous pattern of pigmentation with sharply demarcated moth-eaten borders [2,3]. The most striking features of solar lentigo lesions using Reflectance Confocal Microscopy (RCM) are the polycyclic papillary contours at the dermal-epidermal junction (DEJ) and cord-like structures corresponding to the elongated rete ridges seen in histopathological analysis [4,5]

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