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Actinic keratosis, Bowen disease, and invasive squamous cell carcinoma represent different steps within the disease continuum of squamous neoplasia. Although these stages of squamous neoplasia share common findings, reflectance confocal microscopy may be applied for their differentiation and distinction from other benign or malignant lesions. Hyperkeratosis represents the most important limitation in the evaluation of squamous neoplasia as it may impair the analysis of deeper epidermal and dermal structures significantly.

A 26-year-old apparently healthy man with numerous pigmented skin lesions collapsed during an evening party and was resuscitated from ventricular fibrillation. Hypertrophic cardiomyopathy and subaortic tunnel were disclosed by angiocardiography. A diagnosis of cardiomyopathic lentiginosis/lentigines (multiple), electrocardiographic abnormalities, ocular hypertelorism, pulmonary stenosis, abnormalities of the genitalia, retardation of growth, and deafness (sensorineural) syndrome was made. The patient then underwent treatment with an implantable pacer-cardioverter-defibrillator device. Further evaluation revealed several well-established features of the disorder. This is the first reported case of survival from ventricular fibrillation associated with this rare and little known multifaceted syndrome. Disseminated lentiginosis must prompt clinicians to evaluate such cases further since underlying disorders may be associated with considerable morbidity and, apparently, sudden death.