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What Causes Small Burning And Painful Lumps On Labia Minora?

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Posted on Thu, 7 Apr 2016
Question: Dear Doctor, we are writing regarding a problem my wife (26Yrs) is having.
Its been one year since we married, often she is observing some kind of very tiny bubble kind of things (they are similar to broccoli flower heads) on vaginal area, mostly starting on labia minora, and into the vagina.
We have been observing this for a year now.
When they appear, it hurts with burning sense and irritation.
Does this a serious problem, should we be taking any treatment asap? Please see highlighted area in the attached photo. We are new this portal, kindly be patient if we are not clear in explaining the problem.
We both don't have any history of serious health issues.
Other health information: She is also having thyroid problem and had irregular periods.
doctor
Answered by Dr. Dr. Kakkar (46 minutes later)
Brief Answer:
Kindly provide a few more clearer images and details as below

Detailed Answer:
Hello. Thank you for writing to us

I am Dr. Kakkar. I have read your question and i have also reviewed the image.

I would keep a possibility of lymphangioma circumscriptum Or herpes genitalis Or genital warts.

I would request you to upload a few more clearer images.

Are these lesions persistent?
Or do they disappear? If yes, after how many days do they disappear?
Do they break open to form ulcers?

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Dr. Kakkar (1 hour later)
Dear Doctor, thanks very much for your response. We tried again taking many photos, but not able to show exactly in the image. Please see attached two images.

We suspect that the problem started due to oral sex activity (after).

Seen 3 times in last 12 months (Jan 2015 (painful), April 2015, XXXXXXX 2016 (painful)).

Each time the problem lasted for 4-6 weeks. We are not sure if they have disappeared, but during these three time points, she felt uncomfortable and troublesome.

As per our observation, they have never broken or opened to form ulcers. But if these bubbles or threads are touched with hand, hurts very much.

Similar bubbly texture is seen inside the vagina, she is worrying if these things also related to this outside lesions. Can this happen? Will this problem effect in the pregnancy and born babies, though not a pregnant yet.

What could be the causes for this problem Doctor? Please suggest if this is a serious problem and some treatments need to be taken immediately.





doctor
Answered by Dr. Dr. Kakkar (9 hours later)
Brief Answer:
Vestibular papillomatosis; No active intervention required

Detailed Answer:
Hi. Thank you. I have reviewed the Images.

I am of the view that this condition is vestibular papillomatosis. They don't really look like warts or lymphangioma in close up images. Herpes is unlikely too as the lesions of herpes don't persist for 4-6 weeks. Moreover, lesions of herpes typically break down to form erosions.
Vestibular papillomatosis is an anatomic variant of vulvar mucosal epithelium. It is characterized by smooth or filiform papules/ growths, symmetrically distributed on the inner surface of both labia minora. It can resemble genital warts.
No active intervention is required for vestibular papillomatosis as it is a normal anatomic variation. Reassurance is all that is required. It will not affect preganancy.
Some women with vestibular papillomatosis may report pain. I suggest that she visits a gynecology since her pain could also be due to anxiety and vulvodynia.

Regards
Above answer was peer-reviewed by : Dr. Raju A.T
doctor
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Follow up: Dr. Dr. Kakkar (18 hours later)
Thanks Doctor for your response.

She is complaining of burning sense while urination and when touched the lesions.
We noticed a few times blood discharge while intercourse (4 months back). She is afraid if there is something inside of vagina also which caused bleeding.

Doctor, please don't mind for asking over and again, but kindly assure us that this is not genital warts or some serious problem. We were worried and researched on internet and found similar symptoms like genital warts, so got scared about complications and cervical cancers and all ...and contacted you. Thread like structures, not painful but burning sense. Only two major threads which resembles genital warts images shown in many medical health forums. Rest all bubbles are exactly matching vestibular papillomatosis descriptions.

We will be thankful to you if you could also help us with thyroid problem diagnosis.
She took advance thyroid test yesterday and please see results in the attached image. Could you please suggest if levels are normal.

Kindly refer us or suggest which is the best hospital / doctor / specialty in XXXXXXX if we would like to visit personally later for this problem.
doctor
Answered by Dr. Dr. Kakkar (8 hours later)
Brief Answer:
Papillomatosis; A negative HPV DNA PCR will confirm this diagnosis

Detailed Answer:
Hi.

This is certainly vestibular papillomatosis (VP), not warts. VP can be associated with symptoms like pain, burning sensation and painful penetration (dyspareunia). I suggest her to visit a gynecologist nearby, for an examination as well. That would confirm the diagnosis. If apprehensine she may go for a PCR for HPV DNA test. A negative test will confirm that these are nor warts.
Her thyroid report suggests that her TSH is raised which is an indicator that she is hypothyroid. You may visit an endocrinologist for the same.
I am not aware of any of my colleagues in banglore.

Regards
Note: Consult a Sexual Diseases Specialist online for further follow up- Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Dr. Kakkar

Dermatologist

Practicing since :2002

Answered : 9612 Questions

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What Causes Small Burning And Painful Lumps On Labia Minora?

Brief Answer: Kindly provide a few more clearer images and details as below Detailed Answer: Hello. Thank you for writing to us I am Dr. Kakkar. I have read your question and i have also reviewed the image. I would keep a possibility of lymphangioma circumscriptum Or herpes genitalis Or genital warts. I would request you to upload a few more clearer images. Are these lesions persistent? Or do they disappear? If yes, after how many days do they disappear? Do they break open to form ulcers? Regards