The vulvar biopsy specimen revealed a noncaseating granulomatous lesion composed of epithelioid histiocytes and giant cells surrounded by a thin rim of lymphocytes. Also, there were Schistosoma ova surrounded by granulomatous inflammation. The Schistosoma ova showed a terminal spine characteristic of Schistosoma haematobium. Ziehl-Neelsen, periodic acid–Schiff, and Fite stains were negative for organisms. There was no evidence of schistosomiasis elsewhere in the body.