Patients with genital melanosis may need careful examinations for melanoma
A careful total body examination may be required in patients with genital melanosis, particularly those with any level of histologic atypia in the genital melanosis lesion, for the possibility of melanoma in any body site, according to a recent study.
To determine the potential risk for genital and nongenital melanoma in patients, a retrospective cohort study was conducted. The authors analysed clinical and histologic data from patients (n=41) with genital melanosis to better describe these lesions and the risk they confer for genital and nongenital melanoma.
Genital melanosis may clinically mimic melanoma, according to researchers. However, its typical age of onset is younger than for genital melanoma.
A majority of lesions stabilized or regressed over time. There were five patients found to have a history of melanoma, one of which was in the genital region. Lesions from these patients were more likely to show melanocytes with suprabasal movement (p=0.0101) and to have a higher melanocyte count (p<0.0462).
This study was limited by the relatively small cohort of patients with an average follow-up of only 30.5 months, researchers said.
A previous study had shown that reflectance confocal microscopy could noninvasively differentiate between vulvar melanoma and vulvar melanosis. Two major features were identified with vulvar melanosis: papillae rimmed by bright monomorphous cells and possible presence of a few dendritic bright cells in the basal layer of the epithelium. Vulvar melanoma was also associated with two major characteristics: atypical cells in the epithelium and loss of normal architecture of chorion papillae. [Dermatol Surg 2012;38:1962-7]