The distinct appearance of this entirely macular pigmentation is classic for benign vulvar lentiginosis (also called benign vulvar melanosis).
A 30-year-old woman asks about asymptomatic pigmentation of the vulva. Her sexual partner pointed this out to her. She is quite concerned about the possibility of melanoma.
Key point: The distinct appearance of this entirely macular pigmentation, notably multifocal in distribution, is classic for benign vulvar lentiginosis (also called benign vulvar melanosis). It represents extra production of pigment by melanocytes in the area due to unknown cause.
Treatment: Because there is no risk of malignancy, treatment is not indicated.
Note: Melanoma does arise on genital skin, and actually represents 5% to 11% of all vulvar malignancy. However, it is almost always unifocal in distribution and associated with palpable thickening of the affected skin.