Since some vulvar cancer is a type of skin cancer, the American Cancer Society also recommends self-examination of the vulva using a mirror. Vulvar cancer commonly forms as a lump or sore on the vulva that often causes itching. If you get too much exposure to UV radiation, it can damage the DNA of your skin cells. Vulvar melanoma usually occurs on the labia minora or the clitoris; signs of vulvar melanoma can include a black or brown raised area or a change in the size, shape, or color of a pre-existing mole. Finally, look at your perineum. Also, visually look for any moles, rashes, growths, or lesions. And when you see changes, make an appointment to see your healthcare provider. What is vulva melanosis or vulva melanotic macule? Remember melanosis is harmless but you may assume this is the case yet other serious conditions like melanoma may be the real disorder. The lesions are asymmetric, multifocal, and multicolored. Because these areas are not sun-exposed, it is not generally recognized by women that melanoma can develop in this location. , Saida By the end of the 1970s, pelvic lymphadenectomy was abandoned for the most part. J, Delgado In this study, the epidemiologic, clinical, and dermoscopic characteristics of a large series of cases of vulvar melanosis were followed over time. Dr. Elizabeth Poynor wrote a veryhelpful piece on vulvarmelanoma that we are re-posting below. , Murzaku M. , Ferrari It is important to distinguish them from melanomas by performing biopsy of a representative area. Researchers have identified a range of dermoscopic patterns, including ringlike, globular-like, cobblestone-like, and reticular-like, structureless, and parallel patterns.9,10 Histologically, melanosis is characterized by an increase in pigmentation confined to basal keratinocytes and melanocytes, which are arranged as single cells at the dermo-epidermal junction, without evidence of cytologic atypia.7,11 Occasionally, melanocytes show prominent dendrites.12 Scattered subepithelial melanophages resulting from pigmentary incontinence are usually noted. B, Hood A and B, The presence of very similar pigmented lesions makes it difficult to diagnose atypical melanocytic lesion (A) or melanosis (B) with the naked eye. It includes: Labia majora: two large, fleshy lips, or folds, of skin. Acquisition, analysis, or interpretation of data: De Giorgi, Salvati, Scarf, Maida, Trane, Silvestri, Portelli, Venturi, Covarelli, Massi. B, Dermoscopic examination revealed irregular diffuse pigmentation characterized by the presence of brown and black colors in the absence of other dermoscopic parameters. This is the most accurate way to diagnose nodular melanoma. Moreover, the traditional rule of asymmetry, border irregularity, color variation, diameter greater than 6 mm, and evolving in a new or changing lesion (the ABCDEs) is not useful in the clinical diagnosis of pigmented lesions of the vulva, in which the history of the lesion is often not known.19 Therefore, it is important for all physicians (both gynecologists and dermatologists) who treat patients with these lesions to be aware of their characteristics to arrive at a correct diagnosis without subjecting the patient to unpleasant and often unnecessary biopsies or excisions at this particular site.
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