Differential Diagnosis for Plaque-like Lesions on the Vulva
Single Most Likely Diagnosis
- Fordyce spots: These are small, yellowish or white bumps on the vulva that are usually 1-2 mm in size. They are caused by the abnormal presence of sebaceous glands in the mucous membranes and are generally harmless.
Other Likely Diagnoses
- Vestibular papillomatosis: This condition is characterized by small, skin-colored or pink lesions on the vulva, often resembling cauliflower or finger-like projections. They are usually benign and can be confused with genital warts.
- Molluscum contagiosum: A viral infection that causes small, pearly, or flesh-colored bumps on the skin. The lesions are typically 1-5 mm in diameter and can appear anywhere on the body, including the vulva.
- Lichen simplex chronicus: A condition that results from chronic scratching or rubbing, leading to thickened, leathery skin that can appear as small, plaque-like lesions.
Do Not Miss Diagnoses
- Squamous cell carcinoma in situ (Bowen's disease): Although rare, this is a pre-cancerous condition that can present as small, plaque-like lesions on the vulva. Early detection is crucial to prevent progression to invasive cancer.
- Extramammary Paget's disease: A rare skin cancer that can appear as small, plaque-like lesions on the vulva, often with a red, scaly, or crusted appearance.
Rare Diagnoses
- Lichen planus: An autoimmune condition that can cause small, flat-topped, purple lesions on the vulva, although this is less common.
- Sarcoidosis: A condition that can cause small, plaque-like lesions on the skin, including the vulva, due to the formation of granulomas.
- Leukoplakia: A condition characterized by white patches or plaques on the mucous membranes, including the vulva, which can be a precursor to cancer, although rare in this location.