News

Pigmented Vulvar Lesions Often Require Biopsy


 

HOUSTON — Biopsy should be considered more frequently for pigmented lesions that appear on the vulva, compared with elsewhere on the body, because in this location they are particularly tricky to identify by appearance alone, Dr. Libby Edwards said at a conference on vulvovaginal diseases jointly sponsored by Baylor College of Medicine and the Methodist Hospital.

“It is not that pigmented lesions are likely to be more dangerous on the vulva—they are not. It's just that their appearance is less specific,” Dr. Edwards said in an interview.

“Whereas the importance of pigmented lesions on other areas can usually be gauged relatively well by their appearance, on the vulva, very abnormal-looking lesions may be unimportant and vice versa,” commented Dr. Edwards, a dermatologist who runs a private practice in Charlotte, N.C.

For example, vulvar melanosis—patchy, irregular hyperpigmentation—is a benign condition that can appear indistinguishable from vulvar melanoma.

“You have to biopsy this, it is the only way you can rule out melanoma or pigmented vulvar intraepithelial neoplasia,” she said.

In addition, vulvar melanosis can occur as postinflammatory change associated with lichen sclerosus. “You need to treat any underlying disease, but otherwise there is no treatment for vulvar melanosis,” said Dr. Edwards.

Recommended Reading

Managed Properly, Postbariatric Pregnancy Is Safe
MDedge Family Medicine
Prepregnancy BMI and Gestational Weight Predict Fetal Macrosomia
MDedge Family Medicine
Focused Ultrasound Hones Breast Cancer Ablation
MDedge Family Medicine
Cervical Cancer Vaccine Still Effective at 5.5 Years
MDedge Family Medicine
Ovarian Cancer Blood Test Accuracy Rates Improved
MDedge Family Medicine
Cisplatin May Be Effective Option for Patients Who React to Carboplatin
MDedge Family Medicine
Ductoscope Lights Up Breast Cancer Diagnosis
MDedge Family Medicine
Dilation and History Both Predict Preterm Birth
MDedge Family Medicine
Progesterone Stalls Ripening of Cervix, Prevents Early Delivery
MDedge Family Medicine
Obstetric History, Not Ultrasound, Should Guide Cerclage Decisions
MDedge Family Medicine