Genitourin Med 1987;63:393-395 Benign squamous papillomatosis: case report

SUMMARY Squamous papillae in the vestibule are common. They were once considered to be nor-mal variants of female anatomy, but reports of the viral aetiology of such lesions are emerging. When they are symptomatic, squamous papillae can lead to problems in sexual relationships between healthy partners. Here we report a case that responded well to treatment. Benign lesions in the lower genital tract, which were once considered as normal, are now known to relate to the wide range of disease caused by human papil-loma virus (HPV). Despite strong circumstantial evidence suggesting an association between HPV and lower genital tract neoplasia, final proof that HPV is the causative agent of cervical cancer still remains to be established. It is important to be aware of the various clinical manifestations and take adequate steps to screen the patients. Case report A nulliparous woman aged 29 presented with a two year history of roughness around the vulval skin. She had noticed occasional itching in the vulva and superficial dyspareunia, and an occasional non-offensive brownish discharge mainly after menstru-ation. She had regular sexual intercourse with her fiance, who was her only sexual contact during the previous five years. She was in good health until this episode, which caused her great anxiety as she was due to be married four weeks later. Examination showed a pearly white papillomatous area in the introitus, on the inside of labia minora (fig 1). The extent of the lesions was well defined on hand lens examination. There was minimal clear mucoid discharge. The rest of the external genitalia, vagina, and cervix showed no abnormality. A wet film, Gram stained smears, culture, and serology gave negative results for gonorrhoea, chlamydial infection, anaero-bic vaginal infections, trichomoniasis, candidiasis, and syphilis. A biopsy specimen taken from the papil-lomatous area in the introitus showed fibroepithelia