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April 1990

Melanosis of the Areola

Arch Dermatol. 1990;126(4):542-543. doi:10.1001/archderm.1990.01670280128033

To the Editor.—  Dermatologists rely on the clinical features of pigmented lesions to aid in the early diagnosis of malignant melanoma. The characteristics described by Friedman et al1 as being most predictive of melanoma are asymmetry, border irregularity, color variation, and a diameter greater than 6 mm. There are an increasing number of reports of pigmented lesions fulfilling these criteria that are nonetheless histologically benign. We report a lesion of the areola that we believe is within the spectrum of benign melanosis, which includes melanosis of the vulva, penile lentigo, and labial melanotic macule.

Report of a Case.—  In October 1988, a 25-year-old woman was evaluated for an area of hyperpigmentation of her left areola. This pigmented lesion had been enlarging for 13 months prior to her presentation. She first noticed the lesion as a small "freckle" that slowly increased in size to encircle her areola. A normal pregnancy