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The incidence of pigmented lesions and diffuse hyperpigmentation involving the genitalia is difficult to ascertain, but such lesions can be found in about 10% of white women. Approximately 2% of these are nevocellular nevi (other benign pigmented lesions found here include seborrheic keratoses, melanoses, lentigines, warts, and postinflammatory hyperpigmentation). In general, nevi on the vulva are identical in morphology and histopathology to nevi elsewhere on the body, except for a small subset of nevi in younger women that have the unusual feature of enlarged junctional nests varying in size, shape, and position. Their long-term biologic behavior has not been determined. The histologic and clinical features of these “atypical melanocytic …