Vulval lumps and bumps

Author: Hon A/Prof Amanda Oakley, Dermatologist, Hamilton, New Zealand, May 2011.

The appearance of the vulva is highly variable (see Women's Health Victoria site, "the labia library".

Proliferative lesions affecting the vulva may originate from skin, mucosa or underlying connective tissue.

Skin lesions are mainly typical of those found elsewhere on the body, and are found on the outer aspects of the vulva, the labia majora, extending to the groin. They include benign (harmless) and malignant (cancerous) tumours. They are often classified according to cell of origin.

Cell type Benign lesions Malignant lesions
Melanocyte
  • Melanocytic naevus (mole)
  • Often atypical: larger than in other sites, irregular in pigmentation, with flat and bumpy components
Keratinocyte
Blood vessels
Mesenchymal origin
Fibroblast
Fat (adipose tissue)
Smooth muscle
  • Leiomyosarcoma
Skeletal muscle
  • Rhabdomyoma
  • Rhabdomyosarcoma
Nerve tissue

Viral infections may mimic lesions.

Mucosal lesions occur in the inner aspects of the vulva, where the tissue is nonkeratinised (ie, not scaly).

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