A 25-year-old female with history of multiple contacts presenting with growth on vulva, the probable diagnosis is:

Ans. is a, i.e. Condyloma accuminataRef: Shaw 15th/ed, pl38, 139; Current diagnosis and treatment of sexually transmitted diseases, p92-93KEY POINTS* History of sexual exposure and growths on vulva is consistent with condyloma accuminata.* Condyloma accuminata:- It is a sexually transmitted diseaseQ caused by HPV 6Q, 16,Q and 18.Q- Warts are seen on the vulval area.Q- Warts are common in the regions affected most directly by coitusQ i.e. posterior fourchetteQ and lateral areas of vulva. These verrucous growths may coalesce to form large cauliflower growths.Q- Condyloma is associated with vulval,Q vaginal,Q and cervical cancers.Q- Diagnosis is by colposcopy which shows raised patches of aceto-white epithelium with speckled appearance.QLets also rule out other options.* Verrucous plana:- Hands and face are the most common siteQ, warts are not seen in genital area.- It is usually seen in children.Q- Sometimes, it can also occur in young women, but then face is the most common site involved.Q* Verruca vulgaris:- Here also the site of warts is different; usually affected areas are exposed parts of the bodyQ, handQ, feetQ, nails, arms, and legs, face, and scalp.* Condyloma lata:- Is the growth seen on genitalia in secondary syphilis.Q- The presence of these lesions without any other features of syphilis is very unlikely.