Vulvar Melanoma in Childhood

Genital lentigines and melanocytic nevi with superimposed lichen sclerosus: a diagnostic challenge

“…[17][18][19] A melanocytic nevus rather than an MM should be diagnosed if the following criteria are met: relative symmetry and sharp lateral circumscription of the melanocytic proliferation; the majority of melanocytes are arranged in nests; there is only minimal pagetoid upward scatter; no or only slight nuclear atypia; an intradermal component consisting of typical melanocytes of a nevus without evidence of deep dermal mitotic figures; and the junctional melanocytic hyperplasia is limited to the area above sclerosed collagen bundles. 16 …”

Paediatric vulval lichen sclerosus

“…Only four cases of malignant melanoma of the vulva seen in combination with LS in a prepubescent child have previously been reported in the literature. [32][33][34] It is critical for physicians to realize that malignant melanoma does in fact occur in children and, although rare, it can occur on the vulva, as it can metastasize and follow an aggressive clinical course. 34 Fortunately, 80% of children with melanoma present with stage I disease.…”

“…The diseasefree survival in children is 77% at 5 years and is comparable with adult survival rates with stage I or II disease. 32 It is also important to bear in mind that melanocytic proliferations associated with LS have been documented. 35,36 It is not clear whether or not LS developing in association with vulval melanoma is an immune response to the melanoma.…”

Paediatric vulvar disease

“…However, if there is any suspicion of malignancy as indicated by a changing lesion which increases in size or is irregular in border or colour should be referred for specialist opinion from a dermatologist. Vulvar melanoma, albeit a rare entity, has been reported in children [33].…”