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Giornale Italiano di Dermatologia e Venereologia 1999 June;134(3):243-6

Copyright © 1999 EDIZIONI MINERVA MEDICA

language: Italian

A case of melanosis of the areola clinically simulating malignant melanoma. Dermoscopic analysis

Carli P. 1, De Giorgi V. 1, Massi D. 2, Donati E. 1

1 Università degli Studi - Firenze, Clinica Dermatologica I; 2 Istituto di Anatomia e Istologia Patologica


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Melanosis is a benign, pigmented lesion which mainly occurs on mucous membranes (oral, genital). Histopathologic features include hyperpigmentation of basal keratinocytes and presence of melanophages in the papillary dermis. The number of melanocytes is normal or slightly increased. Mucosal melanosis can clinically simulate malignant melanoma: in such a case clinical diagnosis is unreliable and histologic examination is mandatory. A case of a 28-year-old woman showing a pigmented lesion of the areola clinically mimicking malignant melanoma is reported. Dermoscopic analysis showed the presence of a prominent, thick pigmented network which was regularly distributed in the lesion. Borders of network gradually faded in the periphery. Blotches of diffuse pigmentation were observed in the centre of the lesion. No other dermoscopic parameters were found. The total dermoscopy score was 3.8. Therefore, dermoscopy diagnosis was suggestive of a benign lesion, as confirmed by histologic evaluation (incisional biopsy) showing typical changes of melanosis. In this case of melanosis clinically simulating malignant melanoma the preoperative assessment by dermoscopy addressed the correct diagnosis permitting a conservative management of the lesion.

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