Thin vulvar melanoma: a challenging diagnosis. Dermoscopic features of a case series. 2020

S Vaccari, and A Barisani, and C Salvini, and S Pirola, and E P Preti, and E Pennacchioli, and A D Iacobone, and A Patrizi, and G Tosti
Dermatology, Department of Experimental, Diagnostic and Specialty Medicine, Policlinico Sant'Orsola-Malpighi, University of Bologna, Bologna, Italy.

BACKGROUND Vulvar melanoma (VM) is rare and is often diagnosed late. Dermoscopy may aid in its recognition, differentiating VM from other more common vulvar lesions, such as melanosis and naevi. However, little is known about the dermoscopic features of thin VM. OBJECTIVE To retrospectively analyse a series of histopathologically diagnosed thin VMs and to highlight their most suggestive dermoscopic features. METHODS A multicentre, retrospective study was conducted, including histopathologically proven thin VMs, either intraepidermal or with Breslow thickness ≤ 0.5 mm, diagnosed during the period 2016-2018. We particularly focused on their dermoscopic characteristics to highlight the most suggestive dermoscopic diagnostic clues. RESULTS In total, 14 cases of early-stage VM were included, in women with a mean age at diagnosis of 64.86 years. The most frequently affected sites were the labia minora. Of these, 11 cases were unifocal. Dermoscopy most often revealed structureless areas, grey globules and areas, irregular black-brown dots, blue and white structures, and red areas. CONCLUSIONS In our experience, early-stage VM often exhibits dermoscopic features that are more typical of thicker cutaneous melanomas. Dermoscopy may provide useful clues for the prompt diagnosis of thin VM.

UI MeSH Term Description Entries
D008545 Melanoma A malignant neoplasm derived from cells that are capable of forming melanin, which may occur in the skin of any part of the body, in the eye, or, rarely, in the mucous membranes of the genitalia, anus, oral cavity, or other sites. It occurs mostly in adults and may originate de novo or from a pigmented nevus or malignant lentigo. Melanomas frequently metastasize widely, and the regional lymph nodes, liver, lungs, and brain are likely to be involved. The incidence of malignant skin melanomas is rising rapidly in all parts of the world. (Stedman, 25th ed; from Rook et al., Textbook of Dermatology, 4th ed, p2445) Malignant Melanoma,Malignant Melanomas,Melanoma, Malignant,Melanomas,Melanomas, Malignant
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D005260 Female Females
D005836 Genitalia, Female The female reproductive organs. The external organs include the VULVA; BARTHOLIN'S GLANDS; and CLITORIS. The internal organs include the VAGINA; UTERUS; OVARY; and FALLOPIAN TUBES. Accessory Sex Organs, Female,Sex Organs, Accessory, Female,Genital Organs, Female,Genitals, Female,Reproductive System, Female,Female Genital,Female Genital Organ,Female Genital Organs,Female Genitalia,Female Genitals,Female Reproductive System,Female Reproductive Systems,Genital Organ, Female,Genital, Female,Reproductive Systems, Female
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000369 Aged, 80 and over Persons 80 years of age and older. Oldest Old
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D014844 Vulva The external genitalia of the female. It includes the CLITORIS, the labia, the vestibule, and its glands. Vulvas
D014846 Vulvar Neoplasms Tumors or cancer of the VULVA. Cancer of Vulva,Vulvar Cancer,Cancer of the Vulva,Neoplasms, Vulvar,Vulva Cancer,Vulva Neoplasms,Cancer, Vulva,Cancer, Vulvar,Cancers, Vulva,Cancers, Vulvar,Neoplasm, Vulva,Neoplasm, Vulvar,Neoplasms, Vulva,Vulva Cancers,Vulva Neoplasm,Vulvar Cancers,Vulvar Neoplasm

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