日本性感染症学会誌 Journal of Japanese Society for Sexually Transmitted Infections

Herein, we report the case of a 28-year-old woman presented to our hospital with multiple symmetrical papillary growths on the inner side of the labia minora for 2 months. Papillary growths in her case were diagnosed as class IIIa based on the results of a smear test of her vaginal discharge, and she was referred to a dermatologist. Based on the clinical symptoms and dermoscopic findings, vestibular papillae of the vulva (VP) was diagnosed. Biopsy was performed to rule out any malignancy. Histopathological examination revealed condyloma acuminatum (CA) based on the koilocytic appearance of epithelial cells. Immunostaining for anti-HPV antibodies showed positivity in the perinuclear stratum corneum, rather than in the nuclei of the epithelium. Moreover, immunostaining for p16 and Ki-67 yielded negative results. Therefore, the appearance of koilocytosis was thought to be that of a perinuclear halo. Real-time polymerase chain reaction yielded a weakly positive result (1.10×10^1 copies/0.1 ug of DNA) for HPV type 6. Although the possibility of VP being infected with HPV could not be ruled out, a final diagnosis of VP was reported. Immunostaining for p16 and Ki-67 was useful for distinguishing CA from VP.