Fair-skinnedls of Celtic ancestry are noted to have a peculiar form of acquired pigmented macule variously referred to as "inkspot" lentigos, acquired reticulated ephelids, or reticulated lentigos. A study from a pigmented lesion clinic found these lesions primarily in Celtic patients who had numerous solar lentigines but usually only a single black solar lentigo or inkspot lesion.1 Clinically worrisome for melanoma, these lesions have consistently shown simple basilar hyperpigmentation without melanocytic proliferation or atypia on histologic examination. In our clinic, we have frequently noted these lesions to be multiple. Further, nonmelanoma skin cancers were abundant in patients bearing these lesions.
We have identified 18 patients, all of Celtic ancestry, with lesions clinically and histologically consistent with reticulated ephelids. Inkspot lesions are defined as macular, very dark brown, or black lesions of uniform color with an irregular, reticulated outline (Figure 1). A biopsy specimen was obtained from a representative
Smith SR, O'Grady TC. Reticulated Ephelides: 'Inkspots' Revisited. Arch Dermatol. 1996;132(3):353-354. doi:10.1001/archderm.1996.03890270131026