Vestibular papillomatosis

Background

• Normal anatomical variant commonly mistaken for genital warts/herpes
• Benign and asymptomatic, present in ~1% of women
• Linear, pink, papules symmetrically on the inner aspect of labia minora
• Papules are easily separated at the base

DDx

• Contrast with others:
  • Condyloma acuminata lesions extend outside the vestibule and fuse at the base
  • Vulvar neoplasia has variable presentations but most likely to present as one unique patch - decision to refer for biopsy depends on clinical presentation
  • Genital herpes usually presents with itch, progression from erythematous to vesicular lesions, then rupture forming superficial ulcers
  • Condylomata lata typically involves labia majora and anus

References

Camilla Salvini, MD and Angelina De Magnis, MD. Multiple papillae on labia minora. CMAJ. 2008 Oct 7; 179(8): 799–800.