When the vulva is irritated by inflammation, it can also cause granulomas to develop on the vulva. When there are warts, there are also granulomas due to viral infections. However, to rule out the existence of true warts, a biopsy should be performed to determine whether there are any abnormalities. If necessary, laser surgery should be performed to remove the granulation tissue, and HPV testing should also be performed to rule out HPV infection.