Vulvar Vestibular Papillomatosis is a condition characterized by the presence of multiple papillae covering the surface of the labia minora. It is considered an anatomical variant of the norm. ICD-10 code D28.0.
Vestibular papillomatosis is observed in approximately 1% of women. Previously, this condition was considered a manifestation of HPV infection, but subsequent research has failed to prove this. Today, it is considered an anatomical variant of the vaginal mucosa's structure. Unfortunately, this condition is often confused with anogenital warts, which can lead to unnecessary destructive interventions. It is considered the female counterpart of penile pearly papules.Clinically, the condition presents as thread-like, pinkish papillae forming on the inner side of the labia minora. The diameter of these formations is typically 1 to 2 mm. In most cases, they are asymptomatic, but sometimes there may be itching, burning, and dyspareunia.
Some researchers divide patients with vestibular vulvar papillomatosis into those who are asymptomatic (considered an anatomical variant of normalcy) and those with symptoms of itching, burning, and dyspareunia (considered a manifestation of HPV infection). Further research is needed.Diagnosis is primarily based on the clinical presentation.
Histological findings
Well-defined papillated lesion covered by hyperplastic epidermis with mild spongiosis in foci. An increased number of thin-walled dilated capillaries with a sparse mixed inflammatory infiltrate comprising of lymphocytes, neutrophils, and plasma cells could be presented on the dermis. Koilocytes were absent.
Dermoscopy:
The presence of profuse and irregular vascular channels in multiple cylindrical filiform projections. The bases of the individual projections remain separate. There was no keratotic growth; nor colored dots suggestive of thrombosed vessels, thus, confirming that the lesion was not a wart.- Condyloma acuminatum (Genital warts)
- Syringoma
- Molluscum contagiosum
- Fordyce spots