Melanosis of the vulva: A long-term follow-up from Brisbane, Australia

Object: To determine if vulvar melanosis progressed to melanoma over a period of 20 years or more. Methods: In 2010 the hospital records from the Royal Brisbane Hospital Vulvar Clinic between 1976 and 1988 were reviewed and cross checked with the state wide Queensland Centre for Gynaecological Cancer (QCGC) data base to determine if any patient had been lost to follow up and subsequently developed a vulvar melanoma. Data collected were stored and analysed using the computer software Statistical Package for the Social Sciences (SPSS) 11.0. Results: None of the 12 patients developed vulval melanoma in the years up to 2010. Conclusion: In this small group, followed for more than 20 years, melanosis was not a precursor of melanoma. One patient, who attended the Vulvar Clinic but was not included in this melanosis study, was found to have co-existing melanosis well away from her melanoma in situ and malignant melanoma at presentation. It was not possible to determine if these findings represented a progression of the benign to malignant. Biopsy of abnormal hyper pigmented vulvar skin is recommended. Current knowledge suggests that vulvar melanosis is a benign condition but to be on the safe side follow up of all hyper pigmented vulval lesions to detect early malignant change is recommended.