CONDYLOMA ACUMINATA MASQUERADING IN GENITAL LICHEN SCLEROSUS : AN UNUSUAL COEXISTENCE

Abstract

BACKGROUND- Lichen  Sclerosus is a chronic inflammatory dermatosis commonly affecting post menopausal women and presenting with pruritus and vulvar atrophy. Condyloma acuminata , caused by Human Papilloma Virus (HPV) , typically manifests as verrucous growths in the anogenital region. The coexistence of  HPV- related Condyloma Acuminata within areas of Genital Lichen sclerosus is uncommon and may pose diagnostic difficulty as it may modify  the clinical appearance of the lesions.

CASE PRESENTATION – A 56 year old post menopausal woman presented with a progressively enlarging verrucous growth over the vulva associated with pruritus. Examination revealed a solitary hyperkeratotic lesion measuring 7*5*3 cm with surrounding hypopigmented atrophic skin suggestive of lichen sclerosus. Histopathological examination showed papillomatosis , hyperkeratosis with numerous koilocytes consistent with condyloma acuminate, along with adjacent features of lichen sclerosus.

CONCLUSION – This case highlights an unusual coexistence of condyloma acuminata within genital lichen sclerosus. Careful clinical assessment and histopathological evaluation are essential for the accurate diagnosis and appropriate management in such overlapping presentations.