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Practice Gaps
Oct 2011

Examination of Genital Area: Comment on “Dermoscopy of Pigmented Lesions of the Mucosa and the Mucocutaneous Junction ”

Author Affiliations

Author Affiliations: Dermatology Service, Memorial Sloan-Kettering Cancer Center, New York, New York.

Arch Dermatol. 2011;147(10):1187-1188. doi:10.1001/archdermatol.2011.271

Evaluation of mucosal pigmented lesions (MPLs) is complicated by high rates of benign melanosis, very low rates of melanoma, and the lack of robust clinical features to distinguish between the two. While dermoscopy significantly improves diagnostic accuracy for cutaneous melanoma, not surprisingly, the dermoscopic features of cutaneous melanoma are not directly applicable to MPLs. In this issue of the Archives, Blum et al1 highlight the dermoscopic characteristics of MPLs as a potential aid to clinical diagnosis. This knowledge should help clinicians in managing at least some MPLs. With that said, it should be noted that there are significant logistic barriers beyond time constraints and potential patient embarrassment associated with the dermoscopic examination of mucous membranes. These include the awkwardness of the examination, which places the clinician's face in close proximity to the lesion being evaluated, and the desire to avoid soiling the dermoscope.

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