A 28-year-old woman presents to her family physician complaining that she has a "growth" in her genital area. She states that she first noticed it 3 weeks ago and it seems to have grown somewhat since that time. She has hypothyroidism, for which she takes thyroid hormone replacement. She has no other medical problems and has never had surgery. She has had 3 sexual paners over her lifetime and is currently involved in a monogamous relationship. She has never had a sexually transmitted disease in the past. Examination demonstrates two nontender 6 mm well-circumscribed, flesh-colored, papillated, oval lesions on the labia majora. There is no ulceration, erythema, purulence, or inguinal lymphadenopathy. Which of the following is the most likely diagnosis?
This patient, who presents with asymptomatic, well-circumscribed, benign-appearing, flesh-colored lesions in the genital area most likely has condyloma acuminatum, or genital was. These lesions result from contact with infected paners and represent a sexually transmitted disease. Most of the time these lesions are benign, without carcinogenic potential except if they are associated with the cervix, where they are an impoant etiologic agent for cervical carcinoma. Chancre is characterized as a painless ulcer and is the primary genital lesion of syphilis. This patient did not have an ulceration Herpes simplex lesions are characterized by grouped vesicles on an erythematous base. These lesions are usually symptomatic with a prodrome of burning or irritation. This patient had an asymptomatic lesion without vesicles, ulcerations, erosions, or erythema. Squamous cell carcinoma can present in this location, but usually is characterized with erythema, erosion, or ulceration. Ref: Hoffman B.L., Schorge J.O., Schaffer J.I., Halvorson L.M., Bradshaw K.D., Cunningham F.G., Calver L.E. (2012). Chapter 29. Preinvasive Lesions of the Lower Genital Tract. In B.L. Hoffman, J.O. Schorge, J.I. Schaffer, L.M. Halvorson, K.D. Bradshaw, F.G. Cunningham, L.E. Calver (Eds), Williams Gynecology, 2e
Chancre
Condyloma
Herpes
Squamous cell carcinoma