The role of dermatoscopy to differentiate vulvar vestibular papillomatosis from vulvar condyloma acuminata

Abstract

Vulvar vestibular papillomatosis (VP) and vulvar condyloma acuminata (CA) are distinct conditions that can present similarly, leading to diagnostic challenges. VP is a benign anatomical variant of the vulvar epithelium, whereas CA is a manifestation of human papillomavirus (HPV) infection, often transmitted through sexual contact. Correct differentiation is essential, as VP does not require treatment, while CA necessitates intervention to prevent further transmission. Misdiagnosis of VP as CA can lead to unnecessary investigations and treatments, causing undue patient distress. Dermoscopy, a non-invasive, readily available tool, enhances the accuracy of clinical diagnoses by revealing features not visible to the naked eye. Although dermoscopy has been used in dermatology for various conditions, no local studies have specifically examined its utility in distinguishing VP from CA. This review summarizes key dermoscopic findings that differentiate VP from CA. VP is characterized by uniform cylindrical papillae with irregular vascular channels and separate bases, whereas CA presents as irregular projections with a common base and glomerular vascular structures. Our findings, supported by previous studies, highlight the value of dermoscopy in providing additional diagnostic clues. Incorporating dermoscopy into clinical practice can reduce misdiagnosis, prevent overtreatment, and ensure appropriate management of vulvar lesions.