MUCOSAL MELANOSIS CLINICALLY MIMICKING MALIGNANT-MELANOMA - NONINVASIVE ANALYSIS BY EPILUMINESCENCE MICROSCOPY

Mucosal melanosis can clinically simulate malignant melanoma. In these cases, biopsy and histological examination are necessary to allow a d efinite diagnosis. The purpose of this study was to analyse the dermos copic features of mucosal melanosis: eight cases of genital melanosis clinically simulating malignant melanoma plus two. typical, labial, me lanotic macules were investigated by epiluminescence microscopy (ELM). Diffuse pigmentation was the dominant ELM feature of mucosal melanosi s: in clinically suspicious lesions it appeared non-homogeneous, irreg ularly distributed, heavy in the centre of the lesion, faint at the pe riphery, Conversely, diffuse pigmentation was regular and homogeneous in typical, labial, melanotic macules, The ELM features related to mel anocytes proliferation (brown globules, radial streaming, pseudopods) were absent. Both pattern analysis of ELM criteria and calculation of total dermatoscopy score (from 2.8 to 4.1 in clinically suspicious les ions, 1 in typical, labial, melanotic macules) were suggestive of beni gn lesions. In conclusion, mucosal melanosis shows a peculiar dermosco pic pattern which can be useful in the non-invasive diagnosis of clini cally suspicious (i.e. mimicking malignant melanoma) lesions.