![]() ![]() Due to the poorly associated prognosis determined mainly by the discovery of melanoma in advanced stages, melanoma remains the skin cancer with the highest mortality, the 5-year survival rate being less than 80% and depending on the degree of local tumor extension, lymphatic invasion, and presence of metastases. An interesting phenomenon was observed in the young population diagnosed with melanoma, the cases experiencing an alarming increase between 1999–2006, with a decrease in the next 10 years, dynamics overlapping with the increasing popularity of photoprotection methods and awareness of the danger posed by tanning beds exposure. Regarding the distribution according to sex, in the case of melanomas discovered in adulthood, there is a predominance of cases in males, with a reversal of the phenomenon for melanomas diagnosed between 15–39 years, over 60% of cases appearing in the female population. ![]() The incidence of melanoma has seen a spectacular increase in the last two decades, with over 300,000 new cases in 2018, the most affected countries being Australia and New Zealand (over 33 cases/100,000 inhabitants), the average age of onset of melanoma being 65 years old. This migratory capacity explains why they are distributed and present at the level of a large number of structures: the skin-the basal layer of the epidermis (with an important role in the uniform pigmentation by forming epidermal–melanin units)-the inner ear, gastrointestinal tract and the nerve structures. Melanocytes come from progenitor cells with a high migration capacity. It is a tumor originating in melanocyte cells which are formed during embryogenesis from the neural crest of the trunk. Melanoma is an extremely aggressive tumor with a high metastatic rate, whose diagnosis in advanced stages was associated, until a decade ago, with minimal chances of survival. By highlighting the main risk factors of vulvar and vaginal melanomas, as well as the clinical manifestations and molecular changes underlying these neoplasms, ideally novel therapeutic schemes will, in time, be brought into effect. Our aim is therefore to draw attention to this oftentimes overlooked entity in order to encourage the community to employ various strategies meant to increase research in this area. This, together with the absence of specific treatment guidelines due to the lack of a sufficient number of cases to conduct randomized clinical trials, makes melanomas with this localization a discouraging diagnosis, associated with a very poor prognosis. ![]() Moreover, despite the large number of drugs newly approved in recent decades for the treatment of cutaneous melanoma, especially in the category of biological drugs, the mortality of vulvo-vaginal melanomas has remained almost constant. The location in areas less accessible to periodic inspection determines their diagnosis in advanced stages, often metastatic. While hairy skin and glabrous skin melanomas of the vulva account for 5% of all cancers located in the vulva, melanomas of the vagina and urethra are particularly rare conditions. By contrast with cutaneous melanomas, the incidence of these types of melanomas is constant, being diagnosed in females in their late sixties. In this landscape, one can distinguish melanomas originating in the mucous membranes and located in areas not exposed to the sun, namely the vulvo-vaginal melanomas. Melanomas of the skin are poorly circumscribed lesions, very frequently asymptomatic but unfortunately with a continuous growing incidence.
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