How is vulvar squamous epithelial verrucous hyperplasia diagnosed from symptoms?

  Vulvar squamous epithelial wart-like growths are commonly associated with condyloma acuminata. Condyloma acuminatum is also known as acrocystic warts, genital warts, acral warts, and venereal warts. It is a type of epidermolysis bullosa caused by infection with the human papilloma virus (HPV).  It is often found on the external genitalia, anus, prepuce, perineum, clitoris, cervix, vagina, etc. It has also been reported on the urethra, urethra, rectum, oral cavity, nipples, umbilicus, groin, and interdigital, bladder, and ureteral areas. The basic lesion is a reddish, grayish or pale brown and soft hyperplasia, with a few with more pronounced surface keratinization. The lesions may vary in size, be solitary or clustered, have a lobulated or spiny surface, be moist, have a narrow base or be tipped, or have a non-narrow base on the body of the penis, or have flat warts on the vagina. The appearance of the lesions is often granular, linear, overlapping, papillomatous, cockscomb, cauliflower, myxomatous, and other forms.  The pathological examination reveals that concave hollow cells are the characteristic changes in the pathology of condyloma acuminata, which has an important diagnostic value; followed by the pathological changes such as capillary hyperplasia of dermal papillae, basal cell hyperplasia, spiny cell hyperplasia, incomplete keratinization and dyskeratosis. The disease is generally not difficult to diagnose based on the characteristics of the rash, site of onset, and development combined with a history of possible contact inquiries. Subclinical infections can be isolated or coexist with typical lesions and can be diagnosed with a white acetate test or toluidine blue test. For latent infections, in situ hybridization or polymerase chain reaction (PCR) can be used to confirm.