Introduction/Background Diseases of the genital area cover a broad spectrum of benign and malignant disorders, that range from benign inflammatory conditions to malignant and potentially lethal diagnoses (i.e melanoma). The diagnosis of pigmented genital lesions imposes some diagnostic challenges. The application of dermoscopy can help to differentiate between benign genital lesions and malignant melanoma.

Methodology A systematic literature review of MEDLINE (PubMed) and bibliographic cross-referencing was performed to identify articles covering dermoscopy features of common and atypical nevi, melanosis and melanoma. Articles were included if dermoscopy was performed on genital lesions and dermoscopy features of pigmented genital lesions were described and extractable.

Results A total of 19 articles with 455 dermoscopy cases of genital lesions could be extrapolated from the published literature. Identified dermoscopy criteria for genital melanoma included asymmetry of color and or structure (92%), followed by blue/white or blue/grey veil (69.2%). Genital melanosis showed a diffuse pigmentation in 51.4% and a ringlike pattern in 27.8% of described cases. Features identified in common genital nevi included a homogeneous brown-gray pigmentation or brown structureless areas and were described in 35.1%. A globular pattern was described in 35.7%.

Conclusion Clinically pigmented genital lesions may look alarming, however the application of dermoscopy may help to differentiate benign melanosis and common genital nevi from melanoma.