melanotic macule on vulva Pathology Outlines Melanocytic Lesions of the Vulva
Description
Patients may also develop telangiectasia, papules, and pustules as well as sensation of warmth, known as flushing. Erythematous papules and pustules are commonly present on the nose and cheeks in patients with the papulopustular variant of rosacea

This is the essence of why complete surgical excision of melanoma-in-situ is necessary
Which means we must source it from food or via supplementation

R., O'Keefe J
