Vulvar melanosis (VM) is a benign pigmentation lesion that is clinically similar to melanoma. It is characterized by asymptomatic patches of varying size and color. Since the features of VM are similar to melanoma, it becomes difficult for dermatologists to diagnose the condition accurately. This study aims to assess the clinical and dermoscopic features of VM.

This cohort study included a total of 129 women with VM, which included 87 (67%) menopausal women and 84 (65%) women who had received some type of hormone therapy. Patients’ data on both the clinical and dermoscopic features of the vulvar lesions was obtained. The primary outcomes of the study were clinical, histopathologic, and dermoscopic features of VM and their changes over time.

The most common locations for VM were labia minora (55 [43%]) and labia majora (33 [26%]). Of 129 total cases, 39 (30%) had lesions with increase size and changed color after initial evaluation; however, they stabilized later. No patient exhibited malignant evolution during a median follow-up of 13 years.

The research concluded that VM was a benign condition, and the alterations in the lesions over time did not result in any malignant transformation. However, a minor association between hormonal status and VM may require further research.