[Amelanotic melanoma of the vulva simulating lichen sclerosus et atrophicus]

Malignant melanoma of the vulva is an uncommon disease. The amelanotic subtype is only rarely mentioned. We report a 60-year-old patient with a 6 month history of vulvar pruritus. Ivory lesions combined with erosions and fine "cigarette paper'-like wrinkling were suspicious for lichen sclerosus et atrophicus. Histologically the diagnosis of an amelanotic malignant melanoma was made. Amelanotic melanoma may present with a wide variety of clinical features. Even in the uncommon location of the vulva, amelanotic melanoma should be suspected in any nonhealing nonpigmented lesion.