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Summary Clinical Presentation Symmetrical, velvety, hyperpigmented plaques on the hair-bearing surface of the vulva and groins Histologic Features Papillomatosis and hyperkeratosis but with very mild acanthosis No melanocytic proliferation and no dermal inflammation Differential Diagnosis Lichenified eczema Physiologic hyperpigmentation Takeaway Essentials Clinical Relevant Pearls Symmetrical hyperpigmentation with brown, poorly demarcated, thickened velvet-textured plaques with verrucous excrescences Pathology Interpretation Pearls Papillomatous hyperplasia without acanthosis Hypopigmentation Post-inflammatory Hypopigmentation Clinical Features Cutaneous infections (e.g., syphilis, leprosy, herpes) and many inflammatory conditions (atopic dermatitis, pityriasis lichenoides chronica (PLC), psoriasis, lichen striatus, and lichen sclerosus) can induce post-inflammatory hypopigmentation [25] (Figs

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Dual activation of mc3r and mc4r drives weight loss and reduces food intake in obese primates