Histopathologic examination of the 3 biopsy specimens showed a hyperplastic epidermis with hyperpigmentation of the basal layer and scattered melanophages in the papillary dermis. Hyperkeratosis, increased number of melanocytes, or melanocytic atypia were not observed.
Melanosis of the areola is a rare condition, with only 6 cases reported to our knowledge. It was first described in 19901 within the spectrum of benign melanosis, which includes melanosis of the vulva, penile lentigo, labial melanotic macule, and primary acquired melanosis of the conjunctiva.