The Ringlike Pattern in Vulvar Melanosis

Abstract

Background: Vulvar melanosis is a benign pigmented lesion that may clinically mimic melanoma. Whereas the dermoscopic features of other pigmented skin lesions have been extensively described, little is known about vulvar melanosis.Observations: A retrospective dermoscopic study was conducted on 87 lesions with histopathologically proved melanosis. We describe and define, for the first time to our knowledge, a ringlike pattern, found in 28 of 87 melanotic lesions (32%), characterized by multiple round to oval structures, white to tan, with dark brown, welldefined regular borders. The structureless and globularlike patterns were observed in 18 of 87 lesions (21%), the parallel pattern in 15 (17%), and the cobblestone-like and reticularlike patterns in 4 (5%). A significant association was found between the distribution of multifocal lesions showing a ringlike vs a nonringlike pattern (82% vs 52%; P =.008), whereas a weak association was found between anatomical site and the different patterns (P=.55). The ringlike pattern was frequently combined with multifocality and simultaneous occurrence at the labia majora and the labia minora. Conclusion:Dermoscopy can be useful for the clinical detection of vulvar melanosis, and the ringlike pattern may represent a new dermoscopic clue for the diagnosis of this lesion.

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

“…Up-to-date dermoscopic criteria have been formulated to improve the diagnostic accuracy for melanotic macules/melanosis of the vulva [13,14], but little is currently known about the dermoscopic features of melanocytic and other nonmelanocytic tumors of the vulva [15,16,17,18,19,20]. …”

Vulvar Melanocytic Nevi: A Dermoscopic Investigation

“…One junctional lentiginous melanocytic nevus showed a parallel pattern (fig. 5) indistinguishable from those found in vulvar melanosis, in which pigmentation is arranged according to the furrows and reliefs of the mucosal surface [4]. In contrast, a homogeneous pattern associated with milia-like cysts was observed in the second junctional lentiginous melanocytic nevus examined (fig.…”

“…More recently, in a larger patient series, patterns other than structureless, globular-like and parallel, reticular-like, cobblestone-like and ring-like were also defined and their association with multifocality was noticed as well [4]. …”

“…Nevertheless, analyses of the dermoscopic features of both benign and malignant pigmented mucosal lesions strongly suggest that this technique, due to its noninvasive nature, should also be considered as a complementary diagnostic tool for genital disorders [1,2,3,4,5,6,7]. However, to date, the majority of the dermoscopic data available on pigmented vulvar lesions concern melanosis, whose clinical aspect, despite its benign behavior, can share several features with malignant melanoma.…”

“…However, to date, the majority of the dermoscopic data available on pigmented vulvar lesions concern melanosis, whose clinical aspect, despite its benign behavior, can share several features with malignant melanoma. In contrast, little is known about the characteristics of the other pigmented lesions which affect the vulvar area [1,3,4]. These include seborrheic keratoses and melanocytic nevi (MN), the latter of which, to the best of our knowledge, have not previously been described dermoscopically.…”