Pigmented lesions

Overview
Pigmented lesions are common and in many cases benign. Though many are benign, it is important for the physician to rule out melignancy to ensure it is not dangerous. They will do this with a biopsy to determine the diagnosis. The three most common types are:
 * Nevi
 * Seborrheic keratosis
 * Dermatofibromas

Differential Diagnosis
In alphabetical order:


 * Benign mole
 * Blue Nevus
 * Cafe au lait macule
 * Dermatofibroma
 * Dysplastic nevus
 * Freckle
 * Malignant Melanoma
 * Seborrheic Keratosis
 * Solar lentigo

History and Symptoms

 * Note: changes in skin appearance, lesion size, lesion length, any bleeding or irritation

Biopsy

 * Shave biopsy: tests for actinic keratosis & seborrheic keratoses
 * Deep scoop shave biopsy, excisional biopsy, punch biopsy: tests for dysplastic nevus and melanoma

Treatment

 * Solar lentigines & Freckles: reassurance, lasers or pulse light

Surgery and Device Based Therapy

 * Keratoses: topical cryotherapy

Primary Prevention

 * Sunscreen
 * Annual full skin exams