What are the other Names for this Condition? (Also known as/Synonyms)

• Ink Spot Lentigo
• Reticulated Black Solar Lentigo

What is Reticulated Melanotic Macules? (Definition/Background Information)

• Melanotic macules are dark spots that may be observed on the skin, mucus membranes of the mouth, genitalia, and in the nails. Melanotic macules are benign and no malignant transformation to a melanoma has been recorded
• A macule indicates the presence of a flat, distinct, discolored area of skin less than 1 cm wide. A macule usually does not involve any change in the thickness or texture of the affected skin
• Reticulated Melanotic Macules are observed on the sun-exposed skin of the back, chest, abdomen, and shoulders. This variant is observed on the skin of children and adults, as a net-like pattern (reticulated)
• The presence of numerous melanotic macules on the body may be associated with a variety of syndromes including Carney complex, Peutz-Jeghers syndrome, and LEOPARD syndrome. In such cases, the cause of the condition is genetically-influenced
• In most cases, Reticulated Melanotic Macules are asymptomatic and do not present any significant signs and symptoms. No complications are typically associated with these lesions; although in some cases, the macules may be confused for melanoma in situ (a precancerous skin condition)
• In a majority, no treatment of Reticulated Melanotic Macules may be necessary and the healthcare provider may undertake a ‘wait and watch’ approach. The prognosis is excellent with appropriate treatment. However, the overall prognosis may depend upon the severity of the signs and symptoms of any underlying disorder (if any present)

Who gets Reticulated Melanotic Macules? (Age and Sex Distribution)

• Reticulated Melanotic Macules can be seen in children and adults
• Both male and female genders are affected
• All races and ethnic groups may be observed with these skin spots, although there is a predilection for dark-skinned individuals

What are the Risk Factors for Reticulated Melanotic Macules? (Predisposing Factors)

Presently, there are no risk factors identified for solitary Reticulated Melanotic Macule. In the case of multiple melanotic macules, the following rare genetic conditions may be involved:

• Carney complex
• LEOPARD syndrome
• Peutz-Jeghers syndrome
• LAMB syndrome
• NAME syndrome

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Reticulated Melanotic Macules? (Etiology)

The exact cause of Reticulated Melanotic Macules is presently not well-understood.

• When numerous macules are observed, they may be found in association with certain genetic conditions or syndromes
• When these macules occur in isolation, they are usually sporadic and no associated conditions are observed

The skin condition is not infectious and does not spread from one individual to another through contact.

What are the Signs and Symptoms of Reticulated Melanotic Macules?

The clinical signs and symptoms of Reticulated Melanotic Macules include the following:

• The presence of pigmented irregular ‘mesh-like’ patches on the body. In most cases, the sun-exposed areas of the trunk and shoulders are involved
• The macules form discolored, flat, and asymmetric patterns on the skin
• The color of the macules may be uniform or non-uniform; the color may be in shades brown or black
• The macules may be single or multiple; the borders are usually irregular
• The underlying skin usually remains unaffected; no change in the thickness or texture of the skin is typically observed
• The macules may be present unchanged for many years and some are indistinguishable from a melanoma (a skin cancer type)

How is Reticulated Melanotic Macules Diagnosed?

The diagnosis of Reticulated Melanotic Macules may involve the following procedures:

• The diagnosis is usually made by a complete physical examination and evaluation of medical history and family history
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination, who examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. A skin biopsy is performed to rule out other similar conditions

Note: A skin biopsy is not usually necessary but may be performed if the healthcare provider suspects a malignancy such as melanoma in situ.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Reticulated Melanotic Macules?

The complications of Reticulated Melanotic Macules may include the following:

• The longstanding skin patches can cause emotional stress and cosmetic concerns in some individuals
• The appearance of the pigmented macules may induce a fear of melanoma (which is a type of skin cancer)
• Complications that arise from an underlying genetic condition/syndrome

How is Reticulated Melanotic Macules Treated?

The treatment of Reticulated Melanotic Macules may include the following:

• The healthcare provider may choose to regularly observe the benign lesions; a “wait and watch” approach may be followed once a diagnosis of melanotic macule is established. In such cases, no treatment is generally required
• If required, a surgical excision and complete removal of the macule, primarily to address cosmetic issues, may be undertaken
• Treatment of the underlying associated genetic disorder, if any
• Follow-up care with regular screening and check-ups are encouraged

How can Reticulated Melanotic Macules be Prevented?

There is currently no effective means of preventing Reticulated Melanotic Macules as the cause of this condition is unknown.

What is the Prognosis of Reticulated Melanotic Macules? (Outcomes/Resolutions)

• The prognosis of Reticulated Melanotic Macules is typically excellent with adequate treatment. No malignant transformations of these macules have been recorded
• If these lesions are associated with any genetic disorders, then the overall prognosis depends upon the severity of the signs and symptoms of the disorder

Additional and Relevant Useful Information for Reticulated Melanotic Macules:

Reticulated Melanotic Macule is also called Reticulated Black Solar Lentigo. However, despite the name, no relation to a conventional solar lentigo is observed.