Vulvar Bumps: When to See a Gynecologist or Dermatologist

Q: Vulvar Bumps: When to See a Gynecologist or Dermatologist

Hello Miss 123： It is difficult to diagnose skin lesions based on verbal descriptions. <br>It is advisable to have a gynecologist examine them first.

Genital issues

Hello, doctor.
Recently, I have developed a swollen area in my vulva that resembles a mosquito bite, approximately twice the size of normal.
It feels fluid-filled (not solid) upon touch and has been present for almost a week (it appeared towards the end of my menstrual period).
I have a habit of using panty liners (for several years), and this week I occasionally noticed small brownish stains on the liner where it contacted the affected area.
I initially thought it was a blister caused by prolonged sitting in a warm environment.
Yesterday, while showering, I gently scratched it (not very hard), and today the brownish discoloration has become more pronounced.
Upon inspection, the area is still swollen but has slightly reduced compared to yesterday, and there is a white, pus-filled bump in the center resembling a small elongated grain of rice, with what appears to be a scratch from yesterday's scratching nearby (not certain).

Recently, my living situation includes a mattress with fleas; I haven't slept on it, but I have several bites on my feet and previously had a herpes infection on my hands, which has been seasonal for the past two to three years.
Currently, the situation on my hands is not very noticeable, so it shouldn't be considered a recurrence.
I have experienced folliculitis in the past and have not engaged in sexual activity.
After researching my symptoms online, I suspect it might be herpes, but it differs in size and distribution from typical herpes outbreaks.
It is not itchy; initially, there was pain only when touching the swollen area, and now there is minimal pain when water touches it during bathing.
However, during normal activities, the brownish fluid can stick to my underwear, causing pain when pulled.
Should I see a gynecologist or a dermatologist? Thank you for your response.

123, 20~29 year old female. Ask Date: 2016/10/02

Dr. Huang Yiwen reply Obstetrics and Gynecology

Hello Miss 123: It is difficult to diagnose skin lesions based on verbal descriptions.
It is advisable to have a gynecologist examine them first.

Reply Date: 2016/10/02

More Info

When it comes to the appearance of bumps or lesions in the vulvar area, it is essential to approach the situation with caution and seek appropriate medical advice. Based on the symptoms you described—such as the swollen bump that feels fluid-filled, the presence of a white pustule, and the discoloration of the area—it is advisable to consult a healthcare professional.
Given the nature of your symptoms, you may need to see either a gynecologist or a dermatologist. A gynecologist specializes in female reproductive health and can evaluate any potential gynecological issues, including infections, cysts, or other conditions that may affect the vulvar area. On the other hand, a dermatologist specializes in skin conditions and may be more adept at diagnosing skin-related issues, including infections or inflammatory skin diseases.

In your case, considering the presence of a fluid-filled bump and the potential for infection (indicated by the white pustule), it would be prudent to see a gynecologist first. They can perform a thorough examination, take a detailed medical history, and possibly conduct tests to determine the underlying cause of your symptoms. If the gynecologist suspects a dermatological issue, they may refer you to a dermatologist for further evaluation.

It is also important to consider the context of your symptoms. The fact that you have been experiencing these bumps after your menstrual period and have a history of seasonal herpes simplex virus infections could suggest a viral or inflammatory process. The discoloration and the presence of a potential injury from scratching may indicate a secondary infection, which could complicate the situation.

In addition to seeking medical advice, there are some general recommendations you can follow to help manage your symptoms until you can see a doctor:
1. Avoid Scratching: It can be tempting to scratch the area, especially if it feels itchy or uncomfortable. However, scratching can lead to further irritation or infection.

2. Keep the Area Clean and Dry: Gently wash the area with mild soap and water, and pat it dry. Avoid using harsh soaps or irritants that could exacerbate the condition.

3. Wear Loose Clothing: Tight clothing can cause friction and irritation. Opt for loose-fitting underwear and clothing to minimize discomfort.

4. Monitor for Changes: Keep an eye on the bump and any changes in size, color, or sensation. If you notice any worsening symptoms, such as increased pain, fever, or spreading of the lesions, seek medical attention promptly.

5. Avoid Irritants: If you suspect that your use of pads may be contributing to the irritation, consider switching to breathable options or going without them for a short period to see if symptoms improve.

In conclusion, while it is essential to seek medical advice for a proper diagnosis and treatment, understanding the nature of your symptoms and taking steps to manage them can help alleviate discomfort. Whether you choose to see a gynecologist or a dermatologist, ensure that you communicate all your symptoms and any relevant medical history to facilitate an accurate diagnosis and effective treatment plan.

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