[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-208907-105":3,"detail-sidebar-cat-0-en-105":81,"doc-detail-208907-en":131},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":74,"head_meta":76,"extra_data":78,"updated_unix":80},105,"en","vestibular-papillomatosis-an-important-differential-diagnosis-of-vulvar-papillomas","Vestibular papillomatosis: An important differential diagnosis of vulvar papillomas","","Vestibular papillomatosis (VP) is often regarded as an anatomical variant of vestibular mucosa, but it can be mistaken for genital warts, triggering aggressive diagnostic workups, unnecessary therapy, and patient anxiety. A clinical case of VP is presented, with dermoscopy and reflectance confocal microscopy (RCM) used to distinguish VP from other vulvar papilomatous conditions. Pathologic and imaging findings help clarify the diagnosis and reduce inappropriate 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is vestibular papillomatosis frequently misdiagnosed?","Question",{"text":63,"@type":64},"VP resembles genital warts due to its papillomatous appearance and can lead to confusion during evaluation.","Answer",{"name":66,"@type":61,"acceptedAnswer":67},"How do dermoscopy and RCM help differentiate VP from genital warts?",{"text":68,"@type":64},"Dermoscopy shows regular, often symmetrical and linear papillae with specific vascular channel patterns, while RCM demonstrates increased canalicular blood vessels and inflammatory cells, supporting VP over condyloma.",{"name":70,"@type":61,"acceptedAnswer":71},"What is the clinical importance of correctly diagnosing VP?",{"text":72,"@type":64},"A correct diagnosis prevents unnecessary concern and laboratory tests, avoiding aggressive and anxiety-provoking investigations and 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papillomas Ezgi Ozkur, Tuğba Falay, Aslı Vefa Turgut Erdemir, Mehmet salih Gürel, Cem Leblebici Dermatology Online Journal 22 (3): 9  \nIstanbul Training and Research Hospital  \nCorrespondence:  \nEzgi Ozkur  \nDepartment of Dermatology  \nIstanbul Training and Research Hospital  \n[ezgierdal@hotmail.com](ezgierdal@hotmail.com)  \nAbstract  \nMost authors believe that vestibular papillomatosis (VP) is an anatomical variant of the vestibular mucosa. But VP is sometimes misdiagnosed as genital warts and this can lead to aggressive investigations, therapy, and anxiety in patients. We present a patient with VP. Dermoscopy and reflectance confocal microscopy (RCM) were performed to differentiate VP from other papilomatous diseases of the vulva.  \nIntroduction  \nThe etiology of VP is still controversial. In the past, VP was thought to be a human papilloma virus (HPV) disease but nowadays it is considered an anatomical variant of the vulva and may be considered as the female equivalent of pearly penile papules in men. Owing to its papillomatous appearance, it is sometimes misdiagnosed as genital warts. Therefore, dermatologists should recognize this condition.  \nCase synopsis  \nA42-year-old woman presented to her gynecologist with one-year history of asymptomatic papules on the vulva. A diagnosis of condyloma on the vulva was made and the patient was referred to our clinic for treatment. Many flesh-colored, soft, filiform papillomas, 1 to 2 mm in diameter, were observed. They were symmetrically located along both inner sides of the vulva with some being in groups (Figure 1A) . She had no history of any extramarital sexual contacts. Histopathological examination showed finger-like protrusions of epithelium and also acanthosis and prominent fibrovascular cores; within the stroma blood vessels were seen . There were mild chronic inflammatory cells but no koilocytes were seen and the specimen was negative for HPV DNA by in situ hybridization (Figure 1B) .  \nDermatoscopy with Fotofinder videodermoscope (Fotofinder systems, Germany) demonstrated regular, often symmetrical and linear papillae over the vulvar vestibule and irregular linear vascular channels were observed in the transparent core of papillae (Figure 1C) .  \nRCM was performed with Vivascope 3000® , manufactured by Lucid-Tech Rochester, NY, USA. It revealed an increased number of canalicular blood vessels (seen as thickened, elongated and tortuous dark canalicular structures,(green arrows)) and inflamatory cells in the dermis (seen as round to polygonal refractile cells (red arrows)) (Figure 1D.)  \nFigure 1A. Flesh-colored, soft, filiform papillomas. Figure 1B. Finger-like protrusions of epithelium, acanthosis, and prominent fibrovascular cores within the stroma (haematoxylin-eosin stain: x50) . Figure 1C. Regular, often symmetrical and linear papillae over the vulvar vestibule and irregular linear vascular channels in the transparent core of the papillae. Figure 1D. Increased number of canalicular blood vessels (seen as thickened, elongated and tortuous dark canalicular structures, (green arrows)) and inflamatory cells in the dermis  \n(seen as round to polygonal refractile cells (red arrows))  \nDiscussion  \nIn a prevalence study in London, UK, one per cent of women showed VP [1] . Since then they have been reported under a variety of names: hirsutoid papillomas of vulva, vulvar squamous papillomatosis , micropapillomatosis labialis, and squamous vestibular micropapilloma.  \nThe clinical resemblance and localization of VP has caused controversy about its etiology. VP has been reported with HPV infection, but a consistent association has not been proven. Most recent studies have shown HPV infection is not a cause of vestibular papillomatosis [2-4] . Five clinical parameters were suggested by Moyal-Barranco et al in order to facilitate the differential diagnosis of VP f","cbCaiiEooJnnTdWA","https://ap.wps.com/l/cbCaiiEooJnnTdWA","pdf",184835,"English","# Abstract\n# Introduction\n# Case synopsis\n# Discussion\n# Conclusion","[{\"question\":\"Why is vestibular papillomatosis frequently misdiagnosed?\",\"answer\":\"VP resembles genital warts due to its papillomatous appearance and can lead to confusion during evaluation.\"},{\"question\":\"How do dermoscopy and RCM help differentiate VP from genital warts?\",\"answer\":\"Dermoscopy shows regular, often symmetrical and linear papillae with specific vascular channel patterns, while RCM demonstrates increased canalicular blood vessels and inflammatory cells, supporting VP over condyloma.\"},{\"question\":\"What is the clinical importance of correctly diagnosing VP?\",\"answer\":\"A correct diagnosis prevents unnecessary concern and laboratory tests, avoiding aggressive and anxiety-provoking investigations and treatment.\"}]","Vestibular papillomatosis: An important differential diagnosis of vulvar papillomas | PDF"]