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

• Published in: Journal of the American Academy of Dermatology Vol. 71; no. 6; pp. 1241 - 1249
• Main Authors: Murzaku, Era Caterina, BS, Penn, Lauren A., MD, Hale, Christopher S., MD, Pomeranz, Miriam Keltz, MD, Polsky, David, MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-12-2014
• Subjects: Dermatology; dermoscopy; Diagnosis, Differential; Female; Humans; melanocytic nevi; melanoma; Melanoma - epidemiology; Melanoma - pathology; Melanoma - surgery; melanosis; Nevus, Pigmented - epidemiology; Nevus, Pigmented - pathology; Nevus, Pigmented - surgery; pigmented lesions; reflectance confocal microscopy; Skin Neoplasms - epidemiology; Skin Neoplasms - pathology; Skin Neoplasms - surgery; Vulvar Neoplasms - epidemiology; Vulvar Neoplasms - pathology; Vulvar Neoplasms - surgery; vulvar region; reflectance confocal microscopy; vulvar region; melanoma; melanosis; melanocytic nevi; pigmented lesions; dermoscopy
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2014.08.019

Pigmented vulvar lesions are present in approximately 1 in 10 women and include melanocytic and nonmelanocytic proliferations. Vulvar nevi, melanosis, and melanoma are particularly challenging because of the similarity of their clinical and/or histopathological presentation. As a result, they are often difficult to diagnose, may result in patient and physician anxiety, and can lead to unneeded, potentially disfiguring surgical procedures. Because it is often detected late, vulvar melanoma carries a poor prognosis with associated significant morbidity and mortality, underscoring the importance of prompt recognition and treatment. In this review, we analyze the distinct epidemiologic, clinical, and histopathologic characteristics of vulvar nevi, melanosis, and melanoma, discuss treatment options, and propose a practical, systematic approach to facilitate formulation of a differential diagnosis and initiation of appropriate management.