CHRPE is a benign lesion which is present from birth, pigmented, has well-defined borders, and can gradually depigment in a lacunar fashion over time. Most (typical) CHRPE lesions carry no significance to the patient and, once diagnosed, no follow-up is generally necessary.

However some (atypical) CHRPE lesions can be associated with colonic polyposis syndromes and in certain cases, referral for screening colonoscopy is appropriate.

CHRPE lesions can undergo malignant transformation but this is felt to be extremely rare.

Colour photo of a CHRPE lesion
This CHRPE lesion was incidentally discovered in a 15 year old girl who had no symptoms


These are multiple “bear-track” CHRPE lesions in a 38 year old lady with a strong family history of intestinal polyps and cancer. This patient was referred for screening colonoscopy.