A 54-year-old woman presented with an approximately 2-year history of lesions in the vulvar area, which had increased in number and had become pruritic over the past several months. She had a history of human immunodeficiency virus (HIV) with a normal CD4 count while receiving triple antiretroviral therapy, as well as a history of cervical dysplasia previously treated and followed by her gynecologist. Her family history was negative for similar lesions. On examination, she had numerous discrete monomorphous white to skin-colored keratotic papules involving her labia majora, proximal medial thighs, perineum, and gluteal cleft (Figure 1). The rest of the findings from her skin examination were normal. A biopsy specimen was taken (Figure 2 and Figure 3).
Chen AF, Stirling L, Spock C, Milikowski C. Numerous White Papules on the Vulva—Quiz Case. Arch Dermatol. 2012;148(6):755–760. doi:10.1001/archdermatol.2012.675a
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