One of the more important and unique variants of lentigines are the psoralen + ultraviolet A light (PUVA) lentigines. PUVA lentigines are iatrogenic in nature and occur after medical therapy with PUVA treatment. Patients who have undergone long-term therapy with PUVA have a high risk of developing PUVA lentigines. These lentigines are darkly pigmented macules that occur across the entire body except in the areas that were not exposed to the PUVA therapy. More than half of patients who have undergone prolonged PUVA treatment will develop PUVA lentigines. They are more common in patients with fair skin types and rarely occur in darker-skinned individuals. The lentigines induced by PUVA therapy are permanent and can have disastrous cosmetic consequences. Like all patients undergoing ultraviolet phototherapy, these patients must be routinely monitored for their entire lives, because they are at increased risk for melanoma and non-melanoma skin cancer due to their chronic use of PUVA treatment.

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