By Gary M. White, MD
Penile melanosis (PM) is the presence of dark, irregularly shaped pigmented macules and patches on the penis.
- PM histologically shows melanocytic hyperplasia and hyperpigmentation of the basal epithelium.
- PM is benign, but must be distinguished from melanoma (which is extremely rare on the penis).
- In one study of genital melanosis (both male and female), the average age at presentation was 43 years of age (range 14-78) [JAAD 2017;76;836].
One or several, dark, irregularly shaped pigmented macules and patches develop on the penis. They are completely flat and may expand over time. The inclusion criteria in one review was a single pigmented patch > 1 cm or multiple coalescent macules that added up to 1. 0 cm or more in size [JAAD 2017;76;836].
A biopsy is necessary to establish the diagnosis and exclude any forms of malignancy (e.g. melanoma). A complete skin exam should be performed should exclude melanoma in any body site. Following these lesions photographically and biopsying any new foci is appropriate. The Q-switched ruby laser has been used successfully [BJD 1994;130;663].
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