|Year : 1992 | Volume
| Issue : 6 | Page : 391-392
Vulval varicosities in pregnancy
SN Tolat, RK Gokhale
S N Tolat
Source of Support: None, Conflict of Interest: None
A case of vulval varicosities occurring during pregnancy is reported for its unusual presentation and some complications encountered during its investigation are discussed.
Keywords: Vulva, Varicosities. Pregnancy
|How to cite this article:|
Tolat S N, Gokhale R K. Vulval varicosities in pregnancy. Indian J Dermatol Venereol Leprol 1992;58:391-2
| Introduction|| |
A genital lesion occurring during pregnancy may prove frightening, not only to the patient but if undiagnosed may bother the obstetrician and the dermatologist too. Vulvar varicosities is one such condition.
| Case Report|| |
A 20-year-old near-term primigravida was referred to us for genital lesions of recent onset.
Clinical examination revealed a soft, partly compressible irregular mass on the labia majora with some extension on the labia minora [Figure - 1]. The swelling had a "bag of worms" feel on palpation and was moderately tender. The patient complained of heaviness and discomfort of the perineal region on prolonged standing, but otherwise the lesion was asymptomatic. There was no evidence of oedema, erosions, or ulcerations over the lesion. Regional adenopathy was absent. There were no associated limb varicosities. Systemic examination and routine investigations were normal.
A biopsy of the lesion under local anaesthesia was taken. The procedure was complicated by profuse bleeding from the wound, which had to be arrested by ligation of underlying vessels.
Histology revealed numerous ectatic vessels in the mid-dermis and subcutaneous tissue, which were lined by a single layer of endothelium. This clinched the diagnosis of vulval varicosities. The patient had an uneventful vaginal delivery 3 weeks later. The genital lesions completely regressed a week after delivery.
| Comments|| |
Varicosities of the vulva may occur in the non-pregnant woman due to increased venous pressure combined with a congenital weakness of the vessel walls.  Vulval varicosities in pregnancy usually present with oedema and trophic changes of the overlying skin or are associated with limb varicosities. 
These features being conspicuously absent in our patient, misled us clinically. The "bag of worms" feel of the lesion led us to entertain a differential diagnosis of either a lymphangioma or an isolated neurofibroma. 
The unwarranted biopsy which was complicated by massive haemorrhage was a lesson learnt, which taught us that merely "dollops of delay and the tincture of time" would have proved curative.
Hence we report this case to highlight an uncommon and benign genital lesion, which after its correct clinical diagnosis could have been managed by firm reassurance only.
| References|| |
|1.||Woolf BR. Disease of the vulva. In: Clinical Dermatology (Demis DJ, ad) 16th revision. Philadelphia: J B Lippincott Company, 1989; (4) 28-5, 10. |
|2.||lye FA, Wilkinson DS. Diseases of the Umbilical, Perianal and Genital Regions. In: Textbook of Dermatology (A. Rook, Wilkinson DS, Ebling FJG, Champion RH, Burton JL, ads), 4th edn Bombay: Oxford University Press, 1987; 2163-228. |
|3.||Lewis FM, Lewis-Jones MS, at al. Neurofibromatosis of the vulva. Br J Dermatol 1992; 127, 540-1. |
[Figure - 1]