A 57-year-old woman was seen for numerous whitish to yellowish vesicles over the swollen vulva that were present since young adulthood (Figure 1). Intermittently or continuously, large amounts of milky fluid drained from these vesicles spontaneously or after abrasion. No lymphedema of the lower extremities or vesicles over the thighs were present. The patient denied major trauma. She had a history of chylothorax 20 years previously, without identification of an underlying cause.