Comprehensive Skin Exam in a 25-Year-Old Male: Benign Nevi, Lentigines, and Sun Protection Counseling
by: Ashlee Baldree
At Village Dermatology in Katy and Houston, Texas, we emphasize the importance of routine skin exams for patients of all ages. This case highlights the evaluation of a 25-year-old male presenting with longstanding skin lesions and seeking education about sun protection, mole evaluation, and overall skin health.
Patient Presentation
A 25-year-old male visited our clinic for an evaluation of multiple skin lesions on the upper back and left breast. The lesions had been present for several years, were asymptomatic, and had never been treated. He also sought education about preventing skin cancer, recognizing suspicious growths, and protecting his skin from sun exposure.
The patient had no personal history of skin cancer.
Dermatologic Examination
A comprehensive skin exam was performed, including inspection of the scalp, face, trunk, extremities, nails, and mucosal surfaces. A dermatoscope was used to assess lesions. The exam revealed:
Benign Nevi (Moles): Symmetrical, evenly colored macules and papules distributed throughout the body. No concerning features for malignancy were noted.
Lentigines (Sun Spots): Light tan macules in sun-exposed areas, consistent with chronic sun damage.
Seborrheic Keratoses: Waxy, pigmented growths present on the trunk and extremities, benign and age-related.
Cherry Angiomas: Small, bright red vascular papules scattered across the skin.
Post-Inflammatory Hyperpigmentation: Ill-defined hyperpigmented patches noted on the upper lip, secondary to a prior rash or trauma.
Congenital Nevus: A stable pigmented lesion located near the periumbilical region.
No evidence of skin cancer was identified during this visit.
Counseling and Recommendations
The patient was counseled extensively on:
Sun Protection
Broad Spectrum Sunscreen SPF 30+ applied daily, reapplied every 2 hours during sun exposure.
Use of mineral-based sunscreens containing zinc oxide or titanium dioxide (recommended brands included Elta MD, ISDIN, Supergoop Mineral Sheerscreen, Cerave Mineral SPF 50, and Neutrogena Sheer Zinc).
Protective clothing, wide-brimmed hats, and lip balms with SPF.
Daily use of Vitamin C serum in the morning for antioxidant protection.
Self-Skin Exams
Perform monthly self-checks for changes in size, shape, or color of moles.
Seek medical evaluation if lesions become painful, itchy, bleeding, or rapidly changing.
Expectations
Benign Nevi, Seborrheic Keratoses, Cherry Angiomas, and Congenital Nevi require no treatment unless cosmetic removal is desired.
Lentigines may improve with sunscreen, topical agents, chemical peels, or laser treatments.
Post-Inflammatory Hyperpigmentation often resolves gradually but may take months to years.
Follow-Up
The patient was advised to return in 1 year for a routine full-body skin check or sooner if new or changing lesions appear.
Key Takeaway
This case underscores the importance of early skin evaluations for patients—even young adults with no history of skin cancer. Education on sun protection, skin self-exams, and preventive dermatology plays a vital role in long-term skin health.
At Village Dermatology in Katy and Houston, TX, we provide expert care for patients seeking reassurance about their moles, sun spots, and other skin concerns.
