Читать книгу Ridley's The Vulva - Группа авторов - Страница 66

Vestibular papillae are 1–5 mm thin projections that occur in the vestibule and inner labia minora, and are a normal variant (Figure 2.7). It is suggested that they are the female equivalent of the tiny symmetrical projections found around the coronal sulcus known as penile pearly papules of the penis [20]. Originally, it was thought that the lesions were induced by the human papillomavirus (HPV), but there is now good evidence to the contrary [21, 22]. The normal glycogenation of the cells at the vestibule is often mistaken for koilocytosis, which is another reason for good communication with the pathologist.

Vestibular papillae can be distinguished from viral warts as they are soft and the same colour and texture as the surrounding mucosa. They are symmetrical in distribution and each papilla arises from a solitary base (Figure 2.8), whereas viral warts often coalesce into a single base. Dermoscopy has also been used to distinguish the two entities [23] where the single base of each papilla is again confirmed. The application of 5% acetic acid does not produce acetowhitening in vestibular papillomatosis. They are usually asymptomatic, and no treatment is needed.

Figure 2.7 Vestibular papillae. Multiple filiform projections of the vestibular epithelium.

Figure 2.8 Histology of vestibular papillomatosis. Low power showing papillary projections with normal epithelium each arising from individual base.