Multiple papillae on labia minora

• Published in: Canadian Medical Association journal (CMAJ) 2008-10, Vol.179 (8), p.799-800
• Main Authors: Salvini, Camilla, De Magnis, Angelina
• Format: Article
• Language: English
• Subjects: Adult; Biopsy, Needle; Female; Human papillomavirus; Humans; Immunohistochemistry; Medical diagnosis; Papilloma - diagnosis; Papilloma - pathology; Practice; Prognosis; Reproductive health; Risk Assessment; Vulvar Neoplasms - diagnosis; Vulvar Neoplasms - pathology
• ISSN: 0820-3946; 1488-2329
• DOI: 10.1503/cmaj.080196

A 24-year-old woman was referred to our dermatology clinic for assessment of vulvar papules. They had been present for at least 2 years, during which time she had tried a course of imiquimod 5% cream, a wart treatment. The lesions, aside from causing significant embarrassment, had not changed in number or size and were asymptomatic. The patient had no known history of sexually transmitted infections. Examination revealed multiple tiny, filiform, rosy papules, symmetrically distributed on the inner sides of her labia minora (Figure 1). The papules were not spreading. The projections were easily separated from each other on examination. The affected area was not painful to touch. Lesions of vulvar intraepithelial neoplasia (Figure 2B) are clinically variable and nonspecific. They closely resemble non-neoplastic epithelial abnormalities or shallow verrucocities. They may be dull red and granular, or they may present with a variegated red and white pigmented appearance with interspersed warty areas. The diagnosis can be made only by biopsy. In our case, we decided against biopsy because the clinical presentation was typical for benign disease: all of the papules were separate and symmetrically distributed, whereas neoplasia often presents as a unique patch.