Vaginal hyperpigmentation due to ochronosis.

Background: Ochronosis is a manifestation of alkaptonuria, a rare metabolic disorder. It results in the accumulation of pigment in connective tissues. After several years, ochronosis may produce a distinctive form of degenerative arthritis.
Case: Vaginal ochronosis was diagnosed in an asymptomatic elderly woman with vaginal hyperpigmentation and severe degenerative arthritis.
Conclusion: Vaginal hyperpigmentation is a rare clinical finding that necessitates biopsy.