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.Le texte complet de cet article est disponible en PDF.
Key words : dermoscopy, melanocytic nevi, melanoma, melanosis, pigmented lesions, reflectance confocal microscopy, vulvar region
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| Disclosure: Dr Keltz Pomeranz is on the board of directors for Up To Date and is a consultant for Procter and Gamble. Ms Murzaku and Drs Penn, Hale, and Polsky have no conflicts of interest to declare.