What are the other Names for this Condition (Also known as/Synonyms)

• Melanotic Macula

What is Melanotic Macules? (Definition/Background Information)

• Melanotic Macules are dark spots that may be observed on the skin, mucus membranes of the mouth, genitalia, and in the nails. Melanotic Macules are benign skin lesions and no malignant transformation to a melanoma has been recorded
• A macule indicates the presence of a flat, distinct, discolored area of skin less than 1 cm wide. A macule usually does not involve any change in the thickness or texture of the affected skin
• Based on the location of these macules, they are classified as:
  • Vulvar Melanotic Macule; observed in the vulvar region in females
  • Penile Melanotic Macule; observed in the penis in males
  • Genital Melanotic Macule
  • Melanotic Macule of Oral Mucosa (or Labial Melanotic Macule); seen on the lip, the tongue, inside the mouth
• Based on the variants, they may be classified as:
  • Volar Melanotic Macule, which is seen in the palms and soles
  • Ungual Melanotic Macule, involving the nail apparatus
  • Reticulated Melanotic Macule, developing on the skin due to sun-exposure
  • PUVA-Lentigines, which occurs as a side effect of PUVA therapy given for various skin conditions
• The presence of numerous Melanotic Macules on the body may be associated with a variety of syndromes including Carney complex, Peutz-Jeghers syndrome, and LEOPARD syndrome. In such cases, the cause of the condition may be genetically-influenced
• In most cases, Melanotic Macules are asymptomatic and do not present any significant signs and symptoms. No complications are typically seen with these skin lesions; although in some cases, the macules may be confused for melanoma in situ (a precancerous skin condition)
• The treatment may depend upon the type of Melanotic Macule and its location. In a majority, no treatment may be necessary, and the healthcare provider may undertake a ‘wait and watch’ approach
• The prognosis of Melanotic Macule is excellent with appropriate treatment. However, the overall prognosis may depend upon the severity of the signs and symptoms of any underlying disorder it is associated with

Who gets Melanotic Macules? (Age and Sex Distribution)

• Melanotic Macules are found in individuals of all ages. These lesions are rare in children
• Both males and females are generally affected
• There is no racial or ethnic predilection for this skin condition

What are the Risk Factors for Melanotic Macules? (Predisposing Factors)

Presently, there are no risk factors identified for solitary Melanotic Macule. In the case of multiple macules, the following rare genetic conditions may be involved:

• Carney complex
• LEOPARD syndrome
• Peutz-Jeghers syndrome
• LAMB syndrome
• NAME syndrome

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Melanotic Macules? (Etiology)

The exact cause of Melanotic Macules is not well-understood.

• When numerous macules are observed, they may be found in association with certain genetic conditions or syndromes
• When these macules occur in isolation, they are usually sporadic and no associated conditions are observed

The skin condition is not infectious and does not spread from one individual to another.

What are the Signs and Symptoms of Melanotic Macules?

The clinical signs and symptoms of Melanotic Macules include the following:

• The presence of pigmented skin lesions/spots anywhere in the body; the borders are usually irregular
• The skin, nails, or mucosal surfaces of the body may be involved
• The macules may be single or multiple; they form discolored flat skin patches on the body that are not more than 1 cm in size (though some may grow up to 5 cm)
• The underlying skin or mucosal surface usually remains unaffected; no change in the thickness or texture of the skin is typically observed
• The macules may be present unchanged for many years

How is Melanotic Macules Diagnosed?

The diagnosis of Melanotic Macules may involve the following procedures:

• The diagnosis is usually made by a complete physical examination and evaluation of medical history and family history
• Dermoscopy: Dermoscopy is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
• Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
• Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination, who examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis. A skin biopsy is performed to rule out other similar conditions

Note: Pigmented lesions present a difficult diagnostic challenge. The risk of missing an early malignant melanoma must be minimized. Therefore, a biopsy will frequently be required to determine the correct diagnosis.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Melanotic Macules?

The complications of Melanotic Macules may include the following:

• The longstanding skin patches can cause emotional stress and cosmetic concerns in some individuals
• The appearance of the pigmented macules may induce a fear of melanoma (which is a type of skin cancer)
• Complications that arise from an underlying genetic condition/syndrome
• Treatment complications and medication side effects

How is Melanotic Macules Treated?

The treatment of Melanotic Macules may include the following:

• The healthcare provider may choose to regularly observe the benign lesions; a “wait and watch” approach may be followed, once a diagnosis of a Melanotic Macule is established. In such cases, no treatment is generally required
• If required, a surgical excision and complete removal of the macule, primarily to address cosmetic issues may be undertaken
• Treatment of the underlying associated genetic disorder, if any
• Follow-up care with regular screening and check-ups are encouraged

How can Melanotic Macules be Prevented?

There are currently no effective measures available to prevent the development of Melanotic Macules because the cause of this condition is unknown.

What is the Prognosis of Melanotic Macules? (Outcomes/Resolutions)

• The prognosis of Melanotic Macules is typically excellent with adequate treatment. No malignant transformations of these macules have been recorded
• If these skin lesions are associated with any genetic disorders, then the overall prognosis depends upon the severity of the signs and symptoms of the underlying disorder

Additional and Relevant Useful Information for Melanotic Macules:

• Carney complex comprises a combination of medical conditions that includes multiple tumors, such as myxomas, schwannomas, endocrine disorders, and pigmented skin conditions

Please read more on Carney complex by visiting the following link below:

https://www.dovemed.com/diseases-conditions/carney-complex-cnc/