Vestibular papillomatosis: A differential diagnosis of vulvar condylomas

Abstract

Sir, For a considerable time, vestibular papillomatosis (VP) has been conceived of as a secondary pathology to HPV (human papilloma virus). Nowadays, several authors are reconsidering it as an anatomical variant of the vestibular mucosa. We report a case of VP initially mistaken for vulvar condyloma. A 25-year-old female without any particular medical history presented herself to the gynecologist for genital papules, without functional signs of genital discharge or dyspareunia. A cervicovaginal smear and viral serologies for HIV and hepatitis B and C were negative, and a diagnosis of vulvar condyloma was reached. The patient was referred to the dermatology department for eventual treatment. A clinical examination revealed filiform, flexible, flesh-colored papillae 1–2 mm in diameter located on both edges of the vulva (Fig. 1). A dermoscopic examination found linear, symmetrical papillae in the vulval vestibule with abundant vessels along them (Fig. 2). There was no whitening of the lesions under the acetic acid test. The diagnosis of vestibular papillomatosis was reached, the patient was reassured, and no treatment was prescribed.