A girl in her teens presented with a unilateral itchy nodule on her right labium majus of 4 months’ duration. The patient was born and lived in a rural village in Malawi. Her medical and family history were unremarkable. She did not report fever or malaise. Physical examination revealed a polypoid, rubbery tumor measuring 1.5 cm located on her right labium majus, which obliterated the right labium minus (Figure, A). She did not present with enlarged lymph nodes, and results of the physical examination were otherwise unremarkable. An incisional lesional biopsy was taken (Figure, B and C).