Melanoma of the penis: a clinical dermoscopic case study.

© 2010 The Authors. doi: 10.2340/00015555-0705 Journal Compilation © 2010 Acta Dermato-Venereologica. ISSN 0001-5555 Sir, Mucosal melanoma is an extremely rare malignancy that comprises less than 4% of all melanomas and accounts for less than 2% of all primary penile malignant lesions (1, 2). It is most frequently located on the glans (55%), followed by the prepuce (28%), penile shaft (9%) and urethral meatus (8%) (3). Penile melanoma is a disease of the elderly: median age at diagnosis is 64 years. By contrast, the average age of patients with cutaneous melanoma is younger (40–50 years of age) (1, 4, 5). The 2and 5-year overall survival rates are 63% and 31%, respectively (1). Compared with tumours occurring in cutaneous sites, mucosal melanomas are often thicker: the median depth of invasion at diagnosis is around 3.5 mm, with approximately 50% of cases thicker than 4 mm (4). A problem in clinical practice is recognizing a pigmented penile lesion as a melanoma. Indeed, one of the major mimickers of mucosal melanoma, and thus of penile melanomas, is melanosis. Clinically, despite its benign behaviour, melanosis can, at times, share features with malignant melanoma: asymmetry, irregular borders, multifocality, variegated pigmentary patterns and large size (6). Dermoscopy may prove useful for the differential diagnosis between mucosal melanosis, and other mimickers, and early melanoma. However, its potential role has been limited so far because little is known about the dermoscopic features of penile melanoma (7). We report here a case of a penile melanoma whose dermoscopic features have been investigated.