In children, a patch of skin above the vulva with dark surface and hard lumps inside may be related to folliculitis, vulvar sebaceous cysts, basal cell carcinoma and so on. 1. Folliculitis: If the patient does not pay attention to personal hygiene, it may lead to bacterial infection of hair follicles, causing inflammation of hair follicles. Due to the deposition of melanin, black pimples may appear, which look like hard lumps to touch and are accompanied by pain and itching. 2. Vulvar sebaceous cysts: usually caused by blockage of the sebaceous ducts. With the gradual accumulation of secretion, itching can be caused if secondary infection occurs. Vulvar itching constantly irritates the local skin, which can lead to black papules that look like hard lumps to the touch. 3. Basal cell carcinoma: It may be related to long-term immunosuppression and heredity. It causes lesions of the basal layer of epidermis and its appendages, which are manifested as slow-growing black protuberances and hard nodules on the surface. In addition to the above, black hard lumps on vulva can be seen in other reasons, it is recommended to go to the hospital in time, clarify the cause with the help of doctors, and actively cooperate with doctors to deal with or treat it.