Condition	Distinguishing features	Diagnosis	Treatment
Condyloma lata	Warty white to gray plaque in moist mucous membranes; may secrete fluid	Examination for spirochetes; serology, including Venereal Disease Research Laboratory and rapid plasma reagin testing	Intramuscular penicillin (first-line therapy)9
Epidermoid cysts	Smooth compressible papule or nodule, often with a central punctum	Examination for a dilated central punctum	Surgical removal of cyst wall if symptomatic; otherwise, no treatment necessary10
Fordyce spots	Smooth, 1- to 2-mm, flesh-colored papules on the scrotum or labia	Examination	No treatment necessary11
Granuloma annulare	Smooth, often annular plaques	Biopsy required for genital lesions	Intralesional steroids12
Lichen planus	Smooth, purple, polygonal papules and plaques	History of pruritus; examination may reveal lacy white Wickham striae	Topical or intralesional steroids13
Molluscum contagiosum	Pearly, flesh-colored to brown papules with central umbilication	Examination is usually diagnostic; a short pulse of sprayed liquid nitrogen may reveal central umbilication	Cryotherapy, curettage, or imiquimod (Aldara)14
Pearly penile papules	1-mm white papules arranged circumferentially around the corona or sulcus of the glans penis	Examination	No treatment necessary
Seborrheic keratosis	Well-demarcated, rough, brown verrucous papules	Comedo-like openings and milia-like cysts on dermoscopy	No treatment necessary; cryotherapy and/or curettage for cosmetic treatment
Squamous cell carcinoma	May appear warty, leukoplakic, or sclerotic	Shave or punch biopsy required	Excision13
Vulvar intraepithelial neoplasia	Heterogeneous appearance, but may appear as a red, white, or pigmented irregular plaque on the vulva	Shave or punch biopsy required	Excision; laser ablation; topical therapy with imiquimod, fluorouracil, or other agents15