Pseudo-Warts: Misdiagnosis and Women's Health Concerns

Q: Pseudo-Warts: Misdiagnosis and Women's Health Concerns

Hello： The appearance of the vulva varies from person to person, and some lesions may be difficult to diagnose in the early stages. <br>Without a consultation, it is not advisable to make assumptions about a diagnosis. <br>It is recommended to visit a hospital for a better unders

Pseudocauliflower

On November 29, I visited a doctor due to itching in the vulva, and the doctor said there was a fungal infection in the vagina.
The first doctor examined me and mentioned it looked like genital warts but could also be a hyperplasia; I was advised to wait a few days to see if the swelling subsided.
Hearing this was a huge shock, and I thought, how could this happen? On November 30, due to increased itching and a desire to confirm whether it was indeed genital warts, I went to another gynecologist for an examination.
The second doctor, after a rough examination, confidently told me it was genital warts and that I needed to undergo electrocautery immediately.
This was even more shocking, as I thought, how could this be possible? First, my only sexual partner is my husband, and we always use condoms; he also does not have genital warts.
Second, I always use squat toilets in public restrooms.
Third, I never touch my private areas with towels when staying in hotels.
Later, I researched online and felt it resembled pseudogenital warts, possibly caused by a fungal infection leading to hyperplasia on the inner labia.
Therefore, I decided to undergo treatment, and about a week later, the originally swollen protrusions were less noticeable, but there were still some linear formations resembling hirsutism on the inner labia.
On December 7, I consulted another gynecologist.
The third doctor examined me and said this was not genital warts but rather a skin hyperplasia that matched the color of mucositis.
He mentioned he had seen a few cases like this but not many, and that genital warts are usually firmer and white; mine didn't even resemble flat warts!
I have several questions:
1.
Can there be glandular protrusions on the inner labia? Can a Candida infection cause glandular protrusions on the inner labia?
2.
On the left inner labia, there are several smooth, linear, flesh-colored bumps that feel smooth to the touch without a granular sensation.
Are these sebaceous adenomas or papillomas?
3.
On the right inner labia, there are linear protrusions that are soft and match the color of the inner labia, without a granular sensation, but can be felt as separate lines when touched.
They are not visible as lines on the skin.
When I move them, they clearly appear as separate lines.
Could this be hirsutism of the labia? Are these pseudowarts? Are they a benign proliferation of epidermal cells, possibly a verrucous rash caused by epithelial hyperplasia? On November 29, I noticed more pronounced lines, and after treating the fungal infection, the swelling seemed to decrease, but there are still noticeable fine protrusions.
Is this normal?
4.
The third doctor said it was not genital warts, but the second doctor was very certain it was.
I am still worried it might be genital warts.
I asked the doctor if I could have an HPV test, and the third doctor said it should not be related.
Should I get an HPV test to check for genital warts, or can I self-test with a 5% diluted vinegar solution to determine if it is genital warts?
5.
Can genital warts appear as linear formations? After discovering genital warts, how long does it take for them to multiply if left untreated?
6.
I have had a Pap smear; can it detect genital warts?
7.
Is there a connection between fungal infections and this condition?
8.
I have seen three doctors: the first said it might be, the second said it definitely is, and the third said it is not.
They all have different opinions, and I am genuinely worried.
After finding your consultation service online, I felt a glimmer of hope.
I hope the doctor can help determine whether my condition is genital warts or pseudogenital warts.
Thank you very much for reading my lengthy message! I am truly anxious and seek your answers.
Thank you!

toms, 30~39 year old female. Ask Date: 2013/12/23

Dr. Dong Yuhong reply Obstetrics and Gynecology

Hello: The appearance of the vulva varies from person to person, and some lesions may be difficult to diagnose in the early stages.
Without a consultation, it is not advisable to make assumptions about a diagnosis.
It is recommended to visit a hospital for a better understanding of your condition, or you may choose to consult a larger hospital nearby, which should be helpful for you.
Thank you!

Reply Date: 2013/12/23

More Info

It sounds like you are going through a very challenging and confusing time regarding your health, particularly concerning the symptoms you are experiencing in your genital area. It's understandable to feel anxious when faced with conflicting medical opinions and the possibility of a serious condition like genital warts (also known as condyloma acuminata). Let's address your questions and concerns systematically.

1. Can a yeast infection cause bumps on the inner labia?
Yeast infections, particularly those caused by Candida species, can lead to inflammation and irritation of the vulvar area. This irritation can sometimes result in the appearance of small bumps or changes in the skin texture, but these are typically not true "growths." Instead, they may be due to inflammation or irritation. It’s important to note that while yeast infections can cause discomfort and changes in the skin, they do not typically cause true skin growths like warts.

2. What are the bumps on the inner labia?
The bumps you describe as smooth and skin-colored could be several things, including sebaceous cysts (which are benign and often painless), skin tags, or other benign skin growths. Without a physical examination, it's difficult to provide a definitive diagnosis. A healthcare provider can help distinguish between these possibilities based on their appearance and your medical history.

3. Are the linear bumps indicative of a condition like hirsutism or pseudo-warts?
The linear arrangement of bumps could be related to several benign conditions, including normal anatomical variations or benign skin growths. Hirsutism typically refers to excessive hair growth in women and is not directly related to the bumps you are describing. Pseudo-warts, or benign epithelial growths, can occur but are usually distinct in appearance from true warts.

4. Should you get an HPV test?
If you are concerned about the possibility of HPV and genital warts, discussing an HPV test with your healthcare provider is a reasonable step. HPV testing is typically done through a Pap smear, which can detect high-risk strains of HPV that are associated with cervical cancer. However, it may not directly diagnose external genital warts. If you have specific concerns about warts, a visual examination by a healthcare provider is usually more informative.

5. Do warts appear in a linear pattern?
Genital warts can appear in various forms, including single or multiple lesions, and they may not necessarily present in a linear pattern. They can be flat or raised and may vary in color. If left untreated, warts can multiply, but the rate of growth can vary significantly among individuals.

6. Can a Pap smear detect warts?
A Pap smear primarily screens for cervical cancer and can identify abnormal cells caused by HPV. However, it does not directly diagnose external genital warts. For external lesions, a visual examination is necessary.

7. Can a yeast infection lead to the development of warts?
No, a yeast infection does not cause warts. Warts are caused by the human papillomavirus (HPV), while yeast infections are caused by fungal organisms. They are separate conditions and do not influence each other directly.

8. Conflicting opinions from doctors:
It’s not uncommon for different healthcare providers to have varying opinions based on their experiences and interpretations of symptoms. If you are feeling uncertain, seeking a fourth opinion or consulting a dermatologist who specializes in skin conditions may provide further clarity.

In summary, while your symptoms are understandably concerning, they may not necessarily indicate the presence of genital warts. The best course of action is to continue working closely with your healthcare providers, consider getting an HPV test if you feel it is warranted, and possibly seek a specialist's opinion for a more definitive diagnosis. Remember that many benign conditions can mimic more serious issues, and a thorough examination is key to proper diagnosis and treatment.

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