Significance

• Only about 1 percent of the female population have vestibular papillae. While vestibular papilloma is an uncommon condition, and the papillae themselves are harmless, correct diagnosis is very important. Confusion with genital warts may result in the need for expensive medical testing, and can cause personal trauma.
  
  

Misconceptions

• Some studies have suggested that vestibular papillae might be related to the human papillomavirus, but according to the Archives of Dermatology, a study of 29 patients with vestibular papillae showed that only 6.9 percent had human papillomavirus sequences. In the control group of 25 patients with genital warts, 96 percent showed signs of the virus, suggesting that vestibular papillae are not related to infection.
  
  

Theories/Speculation

• Vestibular papilloma is thought to be a female homologue to a similar male genital condition, called pearly penile plaque. This condition appears as a series of 1 to 3 millimeter bumps running around the surface of the glans, and usually appears in men between the ages of 20 and 40. According to Net Doctor, about 10 percent of men are affected, and these bumps require no treatment.
  
  

Features

• Vestibular papillae are hard to distinguish from genital warts with just a visual inspection, but there are a few differences between the two conditions. Vestibular papillae appear in a symmetrical configuration, and are usually arranged in lines, while genital warts seem to be random. Warts are firm in texture, and pink, red and white in color. Vestibular papillae are the same color as nearby mucosal tissue and soft in texture. Vestibular papillae all have separate basis, while warts tend to have small projections coming from just one base.
  
  

Considerations

• One common test to determine whether a patient has vestibular papilloma or genital warts is called the acetic acid test. Acetic acid, the same acid that makes up vinegar, is applied to the area. If the bumps turn white, they are likely to be genital warts. If they remain pink, or if only the base turns white, they are more likely to be vestibular papillae.