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Human papilloma virus-associated vulvar lesions include condylomas (acuminata and flat), high-grade squamous intraepithelial lesions (HGSIL), as well as invasive squamous cell carcinomas. Unlike cervix (where almost 100% of cancers are HPV-caused), many vulvar squamous cell carcinomas are HPV-independent and tend to be more aggressive than HPV-induced cancers.
Vulvar condyloma is a venereal disease, usually caused by HPV6 and 11. Clinically, they appear as multiple, bulky, soft, elevated, papillary lesions of variable size, sometimes extending into the introitus. Large or extensive lesions around the meatus may extend proximally with formation of urethral or bladder condylomata.
Verruca vulgaris (common wart) caused by HPV2 may occur on the vulva in girls younger than 5 years. These non-venereal lesions may be mistaken for condyloma acuminata and raise the concern of sexual abuse. When diagnosing condyloma acuminata in children, it is advisable to do HPV-typing by ISH or molecular methods to support the diagnosis.
Image source: CDC/Joe Millar.
Vulvar condyloma is a venereal disease, usually caused by HPV6 and 11. Clinically, they appear as multiple, bulky, soft, elevated, papillary lesions of variable size, sometimes extending into the introitus. Large or extensive lesions around the meatus may extend proximally with formation of urethral or bladder condylomata.
Verruca vulgaris (common wart) caused by HPV2 may occur on the vulva in girls younger than 5 years. These non-venereal lesions may be mistaken for condyloma acuminata and raise the concern of sexual abuse. When diagnosing condyloma acuminata in children, it is advisable to do HPV-typing by ISH or molecular methods to support the diagnosis.
Image source: CDC/Joe Millar.