Genital Lumps

Question 1

What is a papule?

Answer 1

A lesion usually <0.5 cm

Question 2

What is a plaque?

Answer 2

A plate-like lesion usually >0.5 cm

Question 3

What is a wheal?

Answer 3

An oedematous papule or plaque with surrounding erythema (flare)

Question 4

What is a nodule?

Answer 4

A deep solid lesion usually >0.5 cm

Question 5

What is a papilloma?

Answer 5

A rounded epithelial mass. Papillomas may be pedunculated (on a stalk). Papillomas due to human papillomavirus may have a cauliflower appearance or feel gritty

Question 6

What is a cyst?

Answer 6

A closed, lined cavity filled with fluid or semi-solid material

Question 7

What is a vesicle?

Answer 7

A blister <0.5 cm

Question 8

What is a bulla?

Answer 8

A blister >0.5 cm

Question 9

What is a pustule?

Answer 9

A small erythematous elevation with central pus

Question 10

What is an abscess?

Answer 10

A localised deep collection of pus

Question 11

What is a furuncle?

Answer 11

A follicle-centred erythematous nodule +/- pus

Question 12

What is a macule?

Answer 12

A flat lesion <0.5 cm

Question 13

What is a patch?

Answer 13

A flat lesion >0.5 cm

Question 14

What are 5 normal variants accounting for genital lumps?

Answer 14

1. Pearly penile papules
2. Parafrenular glands
3. Fordyce spots
4. Vestibular papillae
5. Nabothian follicles

Question 15

What are vestibular papillae?

Answer 15

Rare, usually small, frond-like glands
The appearance is small, smooth projections that look like cobblestones
Unlike warts, vestibular papillae are usually symmetrically placed, but in some patients, the distinction between early, soft genital warts and vestibular papillae can be difficult. In these cases, the management is review in 1-2 months.

Question 16

What are parafrenular glands?

Answer 16

Distinction from warts is usually made by palpation - the glands are typically small, smooth and symmetrical in comparison to warts, which have a rough surface

Question 17

What is the incubation period for MC?

Answer 17

3-12 weeks

Question 18

Which strains of HPV account for GW?

Answer 18

6 and 11 (accounts for 90%)

Question 19

How is HPV acquired?

Answer 19

HPV infects epithelial cells of the skin and mucosa – entry is thought to occur through microabrasions eg, those associated with sexual intercourse

Question 20

How should warts be followed-up if they have prev. responded to treatment?

Answer 20

Patients whose original lesions have responded well to treatment but in whom new lesions are developing, can continue with the current regimen.

Question 21

When should an agent treating warts be changed?

Answer 21

The patient is not tolerating current treatment

There is under 50% response to current treatment by six weeks (8-12 weeks for imiquimod)