obsolete vulvar blue nevus

Vulvar Blue Nevus: An Obsolete Condition

A vulvar blue nevus, also known as an obsolete vaginal blue nevus, is a rare and outdated term that was once used to describe a specific type of skin lesion on the vulva. According to search results [3], pigmented lesions on the vulva should be considered suspicious if they are blue-black in color, have a jagged or fuzzy border, are raised or ulcerated, or exhibit other atypical features.

Characteristics and Differences

In contrast to benign conditions like vulvar melanosis, which presents as brown to blue-black macules/patches [12], a vulvar blue nevus is not a recognized medical term in current literature. However, it was previously associated with nevi of special sites that may show atypical features suggestive of a dysplastic nevus or of a melanoma [4].

Comparison with Other Conditions

Vulvar cancer, an abnormal cell proliferation arising on the vulva and exhibiting malignant potential, is a more serious condition than a blue nevus. The majority of vulvar cancers are of squamous cell origin [9]. In contrast, a blue nevus was considered a benign condition.

Current Diagnostic Approach

For optimal diagnosis, lichen sclerosus should be controlled before excision of the nevus [10]. A morphology-based classification system can help clinicians with the differential diagnosis of these lesions after performing a history and physical examination [11].

References: [3] Consider pigmented lesions on the vulva suspicious if they are blue-black in color, have a jagged or fuzzy border, are raised or ulcerated, or ... [4] Nevi of special sites have been identified as nevi that may show atypical features suggestive of a dysplastic nevus or of a melanoma. [9] Vulvar cancer is an abnormal cell proliferation arising on the vulva and exhibiting malignant potential. The majority are of squamous cell origin. [10] For optimal diagnosis, lichen sclerosus should be controlled before excision of the nevus (J Am Acad Dermatol 2004;50:690, Arch Dermatol 2002;138:77) [11] Some of the disorders causing these lesions are limited to the vulva, while others also involve skin or mucocutaneous membranes elsewhere on the body. This topic provides a morphology-based classification system that can help clinicians with the differential diagnosis of these lesions after performing a history and physical examination. [12] Clinical features: vulvovaginal melanotic

Based on the provided context, it appears that there are some outdated references to "vulvar blue nevi" which might be considered as an obsolete term or concept.

However, I found some relevant information in the search results:

• According to [5], a blue nevus is a benign type of mole that may appear as a blue lump on the skin. It can occur rarely in the vulvovaginal area and are usually located in the vaginal or cervical mucosa (see [8]).
• A blue nevus is typically characterized by being smooth-surfaced, dome-shaped papules that slowly develop from a macule to a papule ([7]).

However, I couldn't find any specific information on "obsolete vulvar blue nevi" as it seems like this term might not be commonly used or recognized in medical literature. The context suggests that the term "vulvar blue nevus" is more related to benign lesions rather than an obsolete concept.

If you're looking for information on signs and symptoms of a specific type of vulvar lesion, I'd be happy to try and help you with that. Please let me know if there's anything else I can assist you with!

Based on the provided context, it appears that there are several diagnostic tests and procedures that can be used to distinguish between different types of pigmented vulvar lesions, including blue nevi.

• Dermoscopy: This is a non-invasive technique that uses a specialized microscope to examine the skin. It can assist in the diagnosis of vulvar naevi and acquired melanocytic nevi presenting with a predominant globular or homogeneous pigmentation pattern [15].
• Histopathology: This involves examining tissue samples under a microscope. Histopathology shows groups of benign nevus cells in the basal epidermis, which is characteristic of blue nevi [15].
• Biopsy: A biopsy can be performed to confirm the diagnosis and rule out other conditions such as melanoma. However, it's worth noting that a skin biopsy should only be performed in case of clinical doubts, and the established diagnosis of lichen sclerosus based on clinical features is usually sufficient [6][9].

It's also mentioned that acquired melanocytic nevi of the vulva comprise approximately 10-12% of pigmented vulvar lesions, and blue and Spitz (spindled and epithelioid cell) nevi can occur rarely in the vulvovaginal area [12].

The differential diagnosis of an obsolete vulvar blue nevus, also known as a cellular blue nevus, involves considering various pigmented lesions that may mimic this condition.

Possible Differential Diagnoses:

• Malignant melanoma: This is the most devastating lesion to consider in the differential diagnosis of a blue nevus. However, it's worth noting that malignant blue nevi are extremely rare [7].
• Melanocytic naevus: A benign growth that can appear as a dark brown or black patch on the vulva.
• Dermatofibroma: A small, firm bump that can appear on the vulva due to skin injury.
• Combined naevus: A type of melanocytic nevus that combines features of both junctional and intradermal nevi.
• Compound naevus: A type of melanocytic nevus that has multiple layers of pigment-producing cells.

Other Considerations:

• Vulvar melanosis: Also known as vulvar lentiginosis, this is a condition characterized by the presence of multiple dark brown or black patches on the vulva.
• Post-inflammatory hyperpigmentation: A condition where areas of skin become darker due to inflammation or injury.

Key Points to Consider:

• The clinical differential diagnosis of a blue nevus is broad and requires careful consideration of various pigmented lesions [7].
• Malignant melanoma is a rare but serious consideration in the differential diagnosis of a blue nevus [7].

References:

[1] VA Fitzhugh, 2011 - Multiple vaginal blue nevi are an important differential diagnostic consideration for melanoma of the vagina. [3] SS Austad, 2022 - Its blue to black hue is frequently confused with other darker-pigmented lesions, including malignant melanoma. [4] JMT Moran, 2024 - The differential diagnosis can include melanocytic lesions such as benign melanocytic nevi and melanoma as well as non-melanocytic lesions. [9] Differential diagnosis for blue naevus - Malignant melanoma. · Dermatofibroma. · Melanocytic naevus. · Combined naevus. · Compound naevus. · Neurofibroma. [10] The clinical differential diagnosis of vulvar melanoma includes pigmented and non-pigmented lesions, such as syringomas and Fox-Fordyce disease.