Ulcers and Lumps on the Vulva

CLINICAL DIAGNOSTIC MANUAL

Ulcers and lumps on the vulva are clinical findings that may indicate a variety of conditions, ranging from infections to benign and malignant lesions.

Ulcers are areas of skin or mucosal loss that can be painful and may be associated with infection or inflammation.

Lumps can be solid or cystic masses, often related to infections, glandular obstructions, or neoplasms. A detailed clinical evaluation and additional testing are essential to determine the underlying cause and plan appropriate treatment.

Condition	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmatory Diagnosis
Vulvar Warts (Condyloma Acuminatum)	Wart-like lumps on the vulva, sometimes itchy	Presence of wart-like lesions, history of HPV exposure	Wart biopsy, HPV DNA testing
Urethral Carbuncle	Painful ulcer, fever, general malaise	History of previous skin lesions, systemic symptoms	Lesion culture, blood cultures
Bartholin Cyst	Palpable mass in the lower third of the labia majora, pain when walking or sitting	History of vulvar pain and palpable mass	Physical examination, ultrasound to assess the extent of the cyst
Vulvar Abscesses	Painful mass, erythema, local heat, possible purulent drainage	History of pain and inflammatory mass, physical examination	Culture of purulent drainage, ultrasound to assess the extent of the abscess
Herpes Simplex	Painful vesicles progressing to ulcers, itching, dysuria	History of recurrent outbreaks of vesicles and ulcers, symptoms of itching and dysuria	PCR for herpes virus, viral culture of the lesions
Syphilis	Painless ulcer (chancre), inguinal lymphadenopathy	History of exposure to STIs, presence of painless ulcer	Serological tests for syphilis (VDRL, RPR), FTA-ABS test
Vulvar Carcinoma	Persistent mass or ulcer, pain, bleeding	Presence of suspicious lesions, persistent symptoms	Lesion biopsy, imaging (such as CT or MRI) to assess extent
Contact Dermatitis	Itching, erythema, vesicles	History of exposure to irritants, physical examination revealing erythema and vesicles	Medical history, patch testing