Dermoscopy of Pigmented Lesions of the Vulva: A Retrospective Morphological Study

Abstract

Background: The dermoscopic patterns of pigmented skin tumors are influenced by the body site. Objective: To evaluate the clinical and dermoscopic features associated with pigmented vulvar lesions. Methods: Retrospective analysis of clinical and dermoscopic images of vulvar lesions. The χ² test was used to test the association between clinical data and histopathological diagnosis. Results: A total of 42 (32.8%) melanocytic and 86 (67.2%) nonmelanocytic vulvar lesions were analyzed. Nevi significantly prevailed in younger women compared with melanomas and melanosis and exhibited most commonly a globular/cobblestone (51.3%) and a mixed (21.6%) pattern. Dermoscopically all melanomas showed a multicomponent pattern. Melanotic macules showed clinical overlapping features with melanoma, but their dermoscopic patterns differed significantly from those observed in melanomas. Conclusion: The diagnosis and management of pigmented vulvar lesions should be based on a good clinicodermoscopic correlation. Dermoscopy may be helpful in the differentiation of solitary melanotic macules from early melanoma.

Vulvar nevi, melanosis, and melanoma: An epidemiologic, clinical, and histopathologic review

“…Common vulvar nevi are associated with a median age of 28 to 33 years, whereas AMNGT are associated with a younger age of 17 to 26 years. 2,6,9,10 Clinical presentation Common vulvar nevi (Fig 1) present as symmetric macules and flat-topped or dome-shaped papules, ranging in color from pink to dark brown-black, or rarely, blue. 2,3,7 Common nevi are well-demarcated with regular borders, uniform pigmentation, and diameter typically less than 1 cm.…”

“…2,3,7 Common nevi are well-demarcated with regular borders, uniform pigmentation, and diameter typically less than 1 cm. 3,4,8,9,11 They are most often located on the labia majora, labia minora, and clitoral hood. 2 Compared with common vulvar nevi, AMNGT are more frequently located on the labia minora 9 and have an equal distribution between mucosal surfaces and hair-bearing skin of the external genitalia in adults.…”

Pigmente Vulvar Lezyonların Dermoskopi Özelliklerinin İncelenmesi

“…Önceki çalışmalarda vulvadaki melanositik lezyonların hayatın iki döneminde arttığı bildirilmiştir. Buna göre genç adölesan dönemde nevüsler, 60 yaş üzerinde ise melanom insidansı artmaktadır (2). Kadınlarda pigmente vulvar lezyonlar arasında vulvar melanomların görülme oranı son derece düşüktür.…”

“…Jinekolojik muayeneleri sırasında kadınların %12-%19'unun pigmente vulvar lezyonu olduğu görülmektedir. Vulvar bölgede ortaya çıkan hastalıkların yaklaşık %20'sinin pigmente lezyonlar olduğu tahmin edilmektedir (2,3). Kadınlar vulvar bölgelerini nadiren muayene etmektedir.…”

“…Bu nedenle pigmente lezyonların malign ve premalign lezyonlardan ayırımı kritik öneme sahiptir (4,5). Dermoskopi, pigmente deri lezyonlarının çoğunda faydalı, invaziv olmayan, standart bir tanı aracıdır (2). Vulvar pigmente lezyonların dermoskopik paternlerinin tanınması, hem gereksiz biyopsi ve eksizyon gibi invaziv işlemlerin azalmasına yardımcı olur hem de en uygun biyopsi yerinin belirlenmesi amacıyla kullanılabilir (6).…”