A 46-year-old African American woman was referred from the gynecology service for evaluation and treatment of verrucous papules on her vulva. Her history was remarkable for a 15- to 20-year history of severe, erosive, macerated lesions in the intertriginous areas of her genitalia that occurred monthly around the time of her menses and worsened in the summer. She also complained of chronic, severe vulvar pruritis.
On examination, the patient had numerous 2- to 4-mm keratotic, flat-topped papules on her labia minora and majora (Figure 1). She also had widespread hyperpigmentation and papillomatous plaques with mild crusting in the intertriginous regions of her anogenitalia. A biopsy specimen of one of her verrucous papules was obtained (Figure 2 and Figure 3).
Murakawa GJ, Kerschmann R, Berger T. Vulvar Verrucous Papules. Arch Dermatol. 1999;135(2):203-b-208. doi:10-1001/pubs.Arch Dermatol.-ISSN-0003-987x-135-2-dof0299