Painful Hemorrhage of Vestibular Papillae: A Probably Underreported Complication of Vestibular Papillomatosis

Abstract

Vestibular papillomatosis (VP) is a common, harmless, and permanent variation of the vulvar skin for those assigned female at birth. VP manifests as small and flesh-colored bumps on the labia minora (small skin folds surrounding the vagina) and vulvar vestibule (skin under the labia minora). Unlike infections or harmful growths, VP does not pose any health risks and is not associated with sexually transmitted infections (STIs) like human papillomavirus (HPV) or genital warts. In this article, we explore who typically experiences VP, its appearance, texture, color, and how it differs from other vulvar bumps. A 29-year-old woman had a painful red lesion on her labia minora. She had no significant medical history. The lesion was consistent with vestibular papillomatosis and possibly caused by tight clothing. She declined a biopsy and was advised to avoid irritants. After two weeks, the lesion had decreased in size and pain, leading to a diagnosis of self-resolving hemorrhage of a vestibular papilla. Understanding the appearance and behavior of Vestibular Papillomatosis (VP) is crucial for distinguishing it from other genital lesions. Clinicians should be sensitive to patients’ emotional distress and provide appropriate education. Dermoscopy was a valuable tool in diagnosing a case of VP hemorrhage, suggesting a traumatic origin. This case expands our knowledge of VP and emphasizes its consideration in diagnosing genital lesions. More research is needed to understand the impact of VP complications on patients’ quality of life.