Hard lumps in the middle of the anal vulva may be caused by diseases such as perianal abscess, folliculitis, and lipoma. 1. perianal abscess: it is caused by the infection of anal crypt, which spreads to the gap between anal canal and rectum through the drainage of anal glands and lymphatic fluid, thus leading to perianal abscess, which feels like a hard lump. 2. Folliculitis: localized bacteria can easily cause folliculitis, which is a swelling of the local tissues and will appear as a hard knot and a hard lump. 3. Lipoma: It may be malignant, that is, it becomes liposarcoma. The tumor grows quickly and will invade the local and peripheral area, so there will be some hard manifestations. Hard lumps in the middle of the anus and vulva may also be seen in sebaceous cysts, vestibular gland cysts and other diseases. If the symptoms of hard lumps in the middle of the anus and vulva appear and continue to be unrelieved, it is necessary to consult a doctor for treatment in a timely manner, and follow the doctor’s instructions.