Vulvar Seborrheic Keratosis

Vulvar Seborrheic Keratosis

Article
Sexual Health
Skin Care
+3
Contributed byKrish Tangella MD, MBAJan 08, 2019

What are the other Names for this Condition? (Also known as/Synonyms)

  • Seborrheic Keratosis of Vulva

What is Vulvar Seborrheic Keratosis? (Definition/Background Information)

  • Seborrheic keratosis is a very common, benign tumor of the sebaceous gland on skin that resembles a wart. They are associated with itching and may ulcerate and bleed due to intense scratching
  • Vulvar Seborrheic Keratosis is a rare tumor that normally presents as a flesh-colored or dark-pigmented papule on the vulva (area around the external opening of the vagina). It is seen in adult women
  • The cause of development and risk factors for Vulvar Seborrheic Keratosis are unknown. The lesions are not caused by an infection
  • A treatment of Vulvar Seborrheic Keratosis may be undertaken, if they present cosmetic concerns to the individual. In such cases, a simple surgical excision is sufficient treatment. The prognosis is excellent on removal of the tumor

Who gets Vulvar Seborrheic Keratosis? (Age and Sex Distribution)

  • Seborrheic Keratosis of Vulva is rare and observed in adult women
  • This condition is observed worldwide across all racial and ethnic groups
  • However, lighter-skinned individuals (especially Caucasians) are more prone to seborrheic keratosis than darker-skinned individuals (such as Asians, Africans, etc.)

What are the Risk Factors for Vulvar Seborrheic Keratosis? (Predisposing Factors)

No specific risk factors for Vulvar Seborrheic Keratosis have been identified. However, in general, the risk factors for seborrheic keratosis may include:

  • Exposure to sunlight and UV light
  • Skin tanning (use of tanning beds)
  • Caucasians (fair-skinned) are more vulnerable compared to individuals of other (dark-skinned) races

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Vulvar Seborrheic Keratosis? (Etiology)

  • The exact cause and development of Vulvar Seborrheic Keratosis is unknown
  • Even though these tumors resemble warts, they are not caused by a viral infection. Seborrheic Keratosis of Vulva is not a sexually-transmitted disease/condition

What are the Signs and Symptoms of Vulvar Seborrheic Keratosis?

In most cases, Vulvar Seborrheic Keratosis does not present any significant signs and symptoms. However, the following may be noted:

  • Seborrheic keratosis occur as single or multiple tiny skin overgrowths in the vulvar region; the lesions are externally/physically visible
  • The lesions may be dark-pigmented or have a fleshy appearance
  • They are slow-growing tumors that may range in size from a few mm to up to 3 cm
  • Typically, seborrheic keratosis has a “stuck on the skin” appearance (papular lesions) and have well-defined boundaries
  • The nodules are benign and no malignancy occurs in them, even though they may be confused with melanoma (a malignant skin tumor)
  • Seborrheic keratosis is associated with itching, which can lead to constant scratching, a condition known as irritated seborrheic keratosis. This can result in inflammation and bleeding

How is Vulvar Seborrheic Keratosis Diagnosed?

A diagnosis of Vulvar Seborrheic Keratosis may involve the following procedures and tests:

  • Complete physical examination with evaluation of medical history
  • Dermoscopy: It is a diagnostic tool where a dermatologist examines the skin using a special magnified lens
  • Wood’s lamp examination: In this procedure, the healthcare provider examines the skin using ultraviolet light. It is performed to examine the change in skin pigmentation
  • Skin biopsy: A skin biopsy is performed and sent to a laboratory for a pathological examination. The pathologist examines the biopsy under a microscope. After putting together clinical findings, special studies on tissues (if needed) and with microscope findings, the pathologist arrives at a definitive diagnosis

Note: The diagnosis of Seborrheic Keratosis of Vulva may not necessarily involve a biopsy. However, if there is a suspicion of melanoma (due to increased and irregular pigmentation), then the healthcare provider may recommend a biopsy.

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Vulvar Seborrheic Keratosis?

No significant complications generally arise from Vulvar Seborrheic Keratosis; however, the following may be observed:

  • These wart-like growths may present cosmetic concerns, in which case a surgery may be proposed
  • If they are traumatized, severe pain and bleeding with ulceration may occur
  • Bleeding and ulceration can cause infection due to bacteria or fungi
  • Post-surgical infection at the wound site is a potential complication

How is Vulvar Seborrheic Keratosis Treated?

Vulvar Seborrheic Keratosis may not require any treatment in a majority of cases. However, in case they present cosmetic issues to the individual, they may be removed.

  • The healthcare provider may chose to regularly monitor the tumor, if they are asymptomatic. A ‘wait and watch’ approach may be adopted, if a diagnosis of seborrheic keratosis is established
  • A complete surgical excision can help result in a cure
  • Follow-up care with regular screening and check-ups are important

How can Vulvar Seborrheic Keratosis be Prevented?

Current medical research has not established a definitive method to prevent the formation of Vulvar Seborrheic Keratosis.

What is the Prognosis of Vulvar Seborrheic Keratosis? (Outcomes/Resolutions)

  • The prognosis of Vulvar Seborrheic Keratosis is excellent on its complete excision and removal
  • Since, these are benign tumors, the prognosis is excellent, even if no treatment is provided and only periodic observation is maintained

Additional and Relevant Useful Information for Vulvar Seborrheic Keratosis:

  • Seborrheic keratosis is not an infectious condition; they do not spread from one individual to another
  • There is no definitive proof that consuming certain foods influence its development
  • Inverted follicular keratosis of vulva is a subtype of seborrheic keratosis that is seen in the vulva of adult women
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Krish Tangella MD, MBA picture
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Krish Tangella MD, MBA

Pathology, Medical Editorial Board, DoveMed Team

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