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Neurosyphillis

Syphilis is a Sexually Transmitted Infection (STI) caused by the bacteria Treponema Pallidum. It is a systemic infection with a multitude of signs and symptoms depending on the stage of the infection. As such, syphilis is also known as “the Great Imitator” because the clinical presentation may appear similar to many other diseases.

There are four stages of infection: 

  1. Primary syphilis – painless ulcer (or chancre) at the site of infection
  2. Secondary syphilis – manifestations that include, but are not limited to, skin rash, mucocutaneous lesions, and lymph node swelling
  3. Latent syphilis – this stage can last for a number of years with few or no symptoms
  4. Tertiary syphilis  – gummatous lesions (soft, non-cancerous growths), neurological problems, or cardiac symptoms

In this article, we will focus on neurosyphilis. You can learn more about syphilis as an overall topic in a previous article:

What is Neurosyphilis?

Neurosyphilis occurs when the infection reaches the central nervous system i.e. the brain or spinal cord. Neurosyphilis can occur at any stage of infection, but tends to occur in tertiary syphilis. Therefore, neurosyphilis can occur within a few months, but could also develop after 10 to 30 years, of a syphilis infection. 

There are four different forms of neurosyphilis:

  1. Asymptomatic (most common form)
  2. Meningovascular
  3. General paresis (muscle weakness)
  4. Tabes dorsalis (slow degeneration of the neural tracts of the spinal cord)

Asymptomatic neurosyphilis occurs before symptomatic neurosyphilis. Early neurosyphilis affects the blood vessels and meninges (membranous coverings of the brain and spinal cord) whereas late neurosyphilis affects the brain and spinal cord itself.

Signs & Symptoms

Signs and symptoms vary widely depending on the form of neurosyphilis, including:

  • Stroke
  • Changes in personality
  • Dementia, mania, or paranoia 
  • Ataxia (loss of coordination of muscle movements, eg. leading to gait abnormality)
  • Ophthalmic symptoms (eg. blurred vision, reduced color perception)
  • Urinary symptoms (eg. bladder incontinence)
  • Headache
  • Giddiness
  • Hearing loss
  • Seizures 
  • Hyporeflexia 
  • Sensory impairment 

Risk Factors

The risk factors include: 

  • High risk sexual behaviour from unprotected sex and multiple sexual partners
  • Men who have sex with men
  • Recreational drug use

Diagnosis

Syphilis is diagnosed either via blood tests or direct visual inspection using dark field microscopy. In practice, blood tests are more commonly used as they are easier to perform.

To diagnose neurosyphilis specifically, cerebrospinal fluid (CSF), which is a fluid surrounding the brain and spinal cord, is obtained via lumbar puncture and the Venereal Disease Research Laboratory (VDRL) test is performed on the CSF. 

Other laboratory investigations that may be performed include: cerebral angiogram, computed tomography (CT) or magnetic resonance imaging (MRI) scan of the brain, brain stem or spinal cord.

Treatment

Syphilis is treated with intramuscular injection of the antibiotic benzathine benzylpenicillin. Early syphilis is treated with a single dose whereas late syphilis is treated with a once-weekly dose for 3 weeks. 

For neurosyphilis, however, the treatment course is different as penicillin penetrates the central nervous system poorly. Instead, the treatment requires intravenous penicillin every 4 hours for 10 to 14 days.

Generally, follow-up blood tests are performed at 3, 6, 12, 24, and 36 months to ensure the infection has fully resolved. Follow-up lumbar punctures for CSF analysis are performed every 6 months. 

Prevention

Neurosyphilis can be prevented with the following measures:

  • Safe sex practice, namely correct and consistent condom usage
  • Avoiding high risk sexual behaviour. Aside from abstaining from sexual contact, the surest way of avoiding STIs is to be in a mutually monogamous relationship with a partner who has been tested and is free of STIs
  • Regular STI screening and if syphilis has been detected, to receive early and prompt treatment
  • In the case of an individual diagnosed with a syphilis infection, prompt partner notification and treatment helps to reduce the risk of undetected syphilis

 

Do I Have HIV Rash? Or Are They From Other STD Related Rashes?

Skin rashes and lesions are some of the most common signs and symptoms experienced in HIV infection. There is no single definitive HIV rash – individuals may have different types of rashes of varying severity, distribution, and appearance.
As there are many other conditions that can also cause skin rashes, including allergies, autoimmune conditions, and other infections, it is important to remember that there is no way to diagnose someone with HIV based solely on the presence of a rash. Conversely, there is also no way we can rule out HIV just because someone does not have a skin rash. The only way to know for sure is by doing an HIV test at the appropriate time.

Acute HIV Seroconversion HIV Rash

In the primary stage of HIV infection, viral replication progresses quickly and the viral load (VL) will be very high. Your body’s immune system will detect the virus and start producing HIV antibodies to try and fight off the virus – this process is called seroconversion. It is this activity of the immune system which can manifest in the typical symptoms of acute HIV infection, also known as Acute Retroviral Syndrome (ARS) – with fever, swollen lymph nodes, and rashes being the most common symptoms.
The seroconversion HIV rash usually develops around 2-6 weeks from exposure. It will appear as reddish macules (flat lesions) and papules (small swollen bumps) spread over a generalized region, typically over the chest, back, and abdomen, sometimes extending to the arms and legs as well. It can be very itchy for some people, but not always. Symptoms of itch can be reduced by antihistamines and topical creams.
These rashes may last a few weeks or months, but will eventually resolve by themselves, even if the HIV infection has not been diagnosed and treated. This happens as the HIV antibodies bring down the viral load and infected individuals enter the clinically latent stage (chronic HIV infection). Many people may have missed the diagnosis of HIV if they were told by a doctor their rash was due to some allergy or viral flu but did not get tested properly.
HIV-infection

Other Infections

When a person contracts HIV, they are also at increased risk of other infections. Some of these are sexually transmitted and can be contacted at the same time as HIV (e.g. syphilis, herpes simplex virus, etc.), while some can occur later in the disease due to a weakened immune system (e.g. candida/thrush). These infections can also cause skin rashes or lesions to develop, so it is important to look out for any abnormal skin changes if you are concerned about any potential exposure risk, and also to inform your doctor of your concerns.

Syphilis

Syphilis is a sexually transmitted infection caused by the bacteria Treponema Pallidum and is commonly diagnosed together with new HIV infection as they share common risk factors. The primary stage of syphilis infection is a painless chancre or ulcer at the primary site of infection (usually genital, rectal, or oral), but it may go unnoticed by many people. The secondary stage of syphilis is a skin rash which can look very similar to acute HIV rash, with reddish papules around the trunk, arms and legs, and usually over the palms and soles as well – most of the time, this rash is not itchy or painful. Most people who present with a skin rash after potential exposure risk should be tested for both HIV and syphilis together.

Herpes Simplex Virus

Another sexually transmitted infection, herpes simplex virus (HSV) can cause small crops of fluid-filled blisters that can start off looking like a reddish rash. They are usually slightly itchy or painful, and may then burst to form small ulcers which will then dry and crust over. Sometimes, the initial herpes outbreak may be preceded by some viral, flu-like symptoms including fever and swollen lymph nodes. There is no ‘cure’ for herpes, but usually, your immune system will help to control the infection and keep it dormant, although reactivation and clinical outbreaks can still occur (around 2-3x per year on average). Herpes can be contracted both together with acute HIV or can recur frequently in late-stage HIV – persistent or chronic HSV lesions in the setting of untreated or late-stage HIV is considered an AIDS-defining illness, as the immune system has been weakened by the HIV virus and can no longer keep the HSV infection suppressed.

Kaposi Sarcoma

Not quite a rash, but rather an abnormal growth of capillary blood vessel tissues, Kaposi Sarcoma (KS) is actually a type of cancer that can be found in late-stage HIV.
It is caused by an infection with human herpesvirus 8 (HHV-8) which is an opportunistic infection and is also considered an AIDS-defining illness as the transformation of the skin cells only occurs in the presence of a weakened immune system. KS appears as either a single or multiple reddish purplish bumps over the skin or mucous membranes.
They are usually painless and not itchy but can cause other symptoms if they grow on internal organs such as the gastrointestinal tract or the lungs (e.g. GI bleeding, shortness of breath, etc.).
Also, read the 10 Common HIV-Related Opportunistic Infections (IOs)

Candidiasis

Also known as thrush, candida is a very common fungal organism that is found in the environment and can be isolated from around 30-50% of healthy people. Most of the time, it does not cause any symptoms of infection; however, in people with a weakened immune system, there may be an invasive overgrowth of the organism which leads to symptoms. Common areas of candida infection are the nails, skin, mouth/tongue, and genital region. Depending on the region affected, symptoms may include an itchy rash, with scaly or flaking skin, sometimes with a soft whitish layer which can be scraped off.
These are just some of the different types of skin rashes and lesions that may be present in an HIV infection. There is no single type of HIV rash that we can consider to be diagnostic by itself. It is important to assess clinical features of the rash, timing, and potential exposure risk. At the end of the day, the only way to diagnose an HIV infection will be through appropriate HIV testing at any of our clinics.
Join the HIV discussion in our Forum with our Doctors. For HIV Testing, you can walk-in to any of our clinics, for an appointment you can email us at hello@dtapclinic.com.sg, or call any of our clinics.
Take Care. Be Safe!


Other Interesting Reads:

  1. What You Need To Know About HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  2. World AIDS Day (2018) #KnowYourStatus
  3. 4 Things You Need to Know About Penile Health
  4. Sexual Health Advice For Travellers 
  5. What are the Symptoms of HIV Infection and AIDS?
  6. Things You Need to Know about Travelling & HIV PrEP
  7. 11 Causes of Dyspareunia (Pain During Intercourse)
  8. What is HPV Vaccination (Gardasil 9)
  9. 10 Causes of abnormal Vaginal Lumps and Bumps
  10. An Overview of Gonorrhoea
  11. What is the Treatment for Cold Sores? What Causes Cold Sores?
  12. Herpes: Everything You Need to Know!
  13. The HIV Pro-Viral DNA Test can be done 10 days post-exposure.

 

Genital Blisters, Genital Warts and Genital Ulcers – Causes & Treatments

Genital blisters, genital warts, genital ulcers – more common than you think but invariably exceedingly distressing for the person suffering from them. Today we talk a little about the various causes for the above genital skin conditions.
Genital lumps, bumps and sores can be an alarming phenomenon for anyone. One day you notice a tiny little bump, or perhaps several bumps.
Now you’re not sure when they appeared – was your skin normal last week, or did you just never notice the bumps for a good duration? Or perhaps you notice what you thought was a little pimple or an ingrown hair follicle which happens from time to time because you shave. But now it’s burst, leaving a painful raw ulcer.

What are the Causes of Genital Blisters, Genital Warts and Genital Ulcers?

1) What are the Causes of Genital Blisters?

Genital blisters are small, fluid-filled bumps and can occur anywhere over the genital region.

a) Genital Herpes

One of the classic causes of genital blisters is genital Herpes, caused by the Herpes Simplex Virus.
Here’s a video about Herpes

Genital herpes has Several Stages:
Stage 1: Prodrome – the skin appears normal but you may feel an unusual sensation like a tingling or itching. This indicates that the virus is active and heralds an impending outbreak
Stage 2: Redness – you may notice some nonspecific red spots which may be uncomfortable or slightly painful.
Stage 3: Blisters – this is usually when people realise something is not right, Initially, these may resemble tiny pimples. They then grow in size and become fluid-filled and painful.
Stage 4: Ulcers – the blisters burst, leaving shallow, painful ulcers
Stage 5: Scabbing or crusting – a scab or crust forms over the ulcer, which eventually heals
Also, check out What is Oral Herpes & Cold Sore

b) Balanitis

In males, balanitis may sometimes present with tiny blisters. The term “balanitis” is a descriptive term which means inflammation of the head of the penis and foreskin. This usually manifests as skin redness, with some tiny blisters or whitish bumps, as well as possible itching/pain or discomfort.
There can be multiple causes of balanitis. The skin on the penis is no different from skin elsewhere on your body and redness, discomfort and irritation can be caused by many factors:

  • Infections such as fungal skin infections
  • Skin irritation caused by external factors like soaps (irritant or contact dermatitis)
  • Mechanical trauma in the form of excessive friction e.g. masturbation or sexual intercourse with insufficient lubrication
  • Poor hygiene
  • Sensitive skin e.g. in people prone to eczema or dry skin

Depending on the possible underlying trigger or cause, various topical creams may be useful. In some cases, skin swab tests or urine tests may be useful in checking for underlying infections.
Read more about What is a Penile Infection?

2) What are the Causes of Genital Warts?

a) Human Papilloma Virus

This is THE cause of genital warts. Genital warts are skin coloured, fleshy bumps which may occur singly or in clusters around the genital and anal region. They can range from tiny firm bumps to larger, irregular shaped bumps which are classically described as “cauliflower-like” in appearance.
The Human Papilloma Virus (HPV) is a sexually transmitted viral infection. There are many strains of HPV and they are transmitted through sexual contact. Some strains are responsible for genital warts, while other “high risk” strains can lead to an increased risk of cancers such as cervical, oral and anal cancers.
If you have warts, it effectively means you have been infected by at least one strain of HPV. If you are female and you are not already doing your regular PAP smear for cervical cancer, you should do a PAP smear with high risk HPV testing because an individual may have not just one but several strains of HPV. You can read more about PAP smears and cervical cancer screening.
There are various methods available for the treatment of genital warts, ranging from topical medications to freezing or cryosurgery electrosurgery. But one must be prepared that warts can unfortunately recur as the treatment for warts addresses the effects of a HPV infection but does not clear the virus from your body.
The best defence we have against genital warts is the HPV vaccine – Gardasil 9, which provides immunity against certain wart causing strains of HPV.

3) What are the Causes of Genital Ulcers?

When people think of genital ulcers, often the first few causes that spring to mind may be herpes or syphilis. However, genital ulcers can be due to other infections as well as rarer, non-infective causes such as autoimmune diseases.
This is why various tests are useful in differentiating the causes of genital ulcers. The treatment of choice varies drastically depending on what the underlying cause is.
Caused by Sexually transmitted infections (STIs)

  • Herpes Simplex Virus (Common)
  • Syphilis (Common)
  • Chancroid (Rare)
  • LGV (Rare)
  • Donovanosis (Rare)

Non-infective causes

  • Behcet’s (Autoimmune)
  • Crohn’s disease (Autoimmune)
  • Fixed drug eruption (rare causes)
  • Skin Cancer (rare causes)

a) Herpes Simplex Virus

(Painful shallow ulcers and blisters)

As mentioned earlier, both genital blisters and ulcers are different stages of a herpetic flare. A genital skin swab test for the presence of HSV DNA is helpful in confirming HSV as the cause of genital ulcers.

b) Syphilis

(Painless ulcers)

Syphilis can cause ulcers both during its primary and secondary stages.  A chancre, a painless round ulcer, occurs in primary syphilis, while in secondary syphilis, multiple painless ulcers may occur as well. One of the defining traits of a syphilitic ulcer is its painlessness.
These ulcers may be accompanied by other symptoms such as a rash elsewhere on the body.

C) Chancroid

(Multiple painful deep ulcers and swollen groin lymph nodes)
Chancroid is a painful ulcer which is frequently associated with enlarged and painful inguinal (groin) lymph nodes. These are located along your underwear line and may be felt as tender swollen lumps. There are usually several or multiple deep and painful ulcers.
This is caused by a bacterium called Hemophilus ducreyi, which is transmitted through sexual contact. Painful lymph nodes and negative test results for both Herpes and syphilis support this diagnosis. The good news is that antibiotic treatment can clear this up.

Lymphogranuloma venereum (LGV)

Small ulcer, swollen groin lymph nodes, possible rectal pain

Lymphogranuloma venereum (LGV) is an uncommon cause of genital ulcers. It is caused by the bacterium called Chlamydia trachomatis (serovars L1-3). This Chlamydia is different from the “subtype” of Chlamydia trachomat is that causes the common STD you are thinking about. A Rapid Chlamydia & Gonorrhoea PCR test will be about to detect the infection.
The ulcer it causes tends to be small and often goes unnoticed. The lymph node swelling is dramatic and painful and may even discharge pus.
If this was acquired through anal intercourse, inflammation of the anal and rectal canal (known as “proctitis”) can occur, causing rectal pain, bleeding and discharge and diarrhoea.

Donovanosis

Shallow beefy looking ulcers

This is again a rare cause of genital ulcers in the developed world. It is caused by a bacterium called Klebsiella granulomatis and causes shallow ulcers which may bleed easily. This is usually diagnosed with a punch biopsy, which is when a sample of skin tissue is removed for evaluation in the lab.

Other rare causes:

Autoimmune or inflammatory causes, skin cancers, drug reactions

“Autoimmune” diseases occur when your body’s immune system has a tendency to attack itself and one of the many manifestations can be genital ulcers. These are rare and treatment is by a specialist doctor. These ulcers will go away only with good control of the underlying disease.
Sometimes, a bad reaction to a certain medication may cause a persistent, painful ulcer.
Very rarely, genital ulcers may be due to cancer.

All in All

The good news is that most of the above mentioned causes for genital blisters, warts and ulcers can be treated. But an even better step would be to protect yourself from even developing these – safe sexual practices (using barrier protection, doing your regular sexual health screening, and getting the HPV vaccine) are your best bet against these.
Take Care!


  1. HPV Infection & HPV Vaccination for Men who have sex with Men
  2. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  3. How Late Can a Period Be (Delayed Menstrual Cycle)
  4. What are the Causes of Abnormal Penile Discharge?
  5. STD Risk for Receptive Unprotected Anal Sex in Men
  6. Low HIV Risk Doesn’t Mean No HIV Risk
  7. HIV PrEP for Travel – How You Need to Know
  8. An Overview on STD from an STD Doctor
  9. Everything You Need to Know About Herpes Simplex Virus
  10. How Do I Treat Oral Herpes (Cold Sores)
  11. Syphilis Symptoms – Painless Sore & Ulcers
  12. HIV Symptoms – What You Need to Know
  13. 10 Common HIV related to Opportunistic Infections

Syphilis Symptoms & Treatment (Painless STD Sores and Rashes)

What is syphilis?

Syphilis is a sexually transmitted infection (STD) with many different manifestations and potentially serious complications. It is caused by a bacteria called “Treponema pallidum”.
In the past, before the advent of antibiotics, syphilis was considered a dangerous illness with long-term, devastating consequences which could even affect the brain and nerves.
Thankfully, with the development of penicillin antibiotics and lab tests to detect syphilis infection early, modern medicine is now well equipped to diagnose, treat and cure syphilis well before complications can set in.

Syphilis – Still a Real and Relevant Infection Today

As of recent years though, there has been a rise in syphilis cases amongst both heterosexuals as well as homosexual couples, as reported by the Centers for Diseases Control (CDC), a reminder that syphilis remains a very real infection concern that any sexually active individual should be aware of.
Syphilis is transmitted by direct contact with a syphilis sore, which is a painless ulcer known as a “chancre”. These chancres can occur both in the mouth/oral cavity or in the genital region and the rectum. Sexual contact in the form or oral, vaginal or anal intercourse can all spread syphilis. If a pregnant mother has syphilis, she can also transmit it to her unborn child.

What are the symptoms and different stages of syphilis?

Reading about syphilis can be confusing because it is an infection with different stages and a multitude of varied symptoms.
But to simplify things, there are three stages of syphilis: primary, secondary and tertiary.

Primary Syphilis Symptoms

(usually begins a few weeks up to 3 months from infection)

a.) Syphilis Symptoms: Chancres
  • Painless, round ulcer
  • usually single – occurring at the site where the infection enters the body which is usually in the genital, anal or oral region
  • lasts between 3 – 8 weeks

Note that chancres will heal by themselves and disappearance of the chancre does not mean the infection is gone!

Secondary syphilis

(months or more after initial infection)

b.) Syphilis Symptoms: Rashes
  • Syphilis is known in the medical world as “the Great Mimicker” – so keep in mind that the rash it causes may look very different from what you see in photos!
  • The classic rash is a brownish rash over the palms and soles but syphilis can also cause a rash anywhere over the body
  • May range from very faint rashes to obvious reddish patches
  • Generally not itchy
  • Can occur anytime from when the initial chancre is healing to weeks after
  • May come and go
c.) Snail track ulcers
  • Raw reddish ulcers in the mouth and genital region
d.) Condylomata Lata
  • Raised, greyish patches that occur in moist regions of the body like the groin, armpits
e.) Nonspecific symptoms
  • Fever
  • Enlarged lymph nodes
  • A sore throat

Tertiary syphilis

(occurs decades after initial infection)

  • Tertiary syphilis is now fairly rare as most cases are detected and treated before they progress to this. Symptoms depend on the organs affected by syphilis

NOTES:
Someone with syphilis can also feel entirely well and not have any symptoms- this is known as latent syphilis. If the infection was acquired within the last year, it is considered early latent syphilis, but if it occurred more than a year ago, then it is considered late latent syphilis.
Syphilis can affect the eyes and nerves during any stage of infection. This can result in a variety of symptoms including vision problems, abnormal body movements and even early dementia or memory problems.

What Does a Syphilis Test Do

Who should test for syphilis and what tests are done to diagnose syphilis?

You should test for syphilis…

  • If you have had sexual contact with someone with known syphilis
  • If you have symptoms suspicious for syphilis
  • As part of your regular STD screening if you have an active sex life and have had partners whose infection status you are unsure of

Diagnosis of a syphilis infection is done through a blood test which looks for antibodies to syphilis. Syphilis blood tests can be a little complex and your doctor will be able to explain more to you about the interpretation of results and what to look out for.

What Treatment is Available for Syphilis?

Syphilis infections are treated with penicillin which is administered as an injection. The dosage or number of injections required depends on the stage of the infection.
In unfortunate cases where the infection fails to clear up with initial treatment (which is known as treatment failure), then additional antibiotics may be required for a longer duration of time.
In order to determine if treatment is successful, as well as to monitor for recurrence of the syphilis infection, regular blood tests at intervals of a few months may be required. Until one is clear of syphilis, it is best to abstain from the sexual activity so as to minimise the risk of transmitting the infection to others.
Syphilis remains a problem in the present day, but while it is a potentially serious infection, the good news is that with early diagnosis, the frightening complications that occur with untreated syphilis can very easily be prevented.

Take Care!

Other Interesting Reads:

  1. An Overview of STD – From an STD Doctor
  2. Weak Erection? Erectile Dysfunction? How to Improve Erection with Pills
  3. Do I Have HIV Rash? Or Are They Other STD-Related Rashes?
  4. What are the Causes of Abnormal Penile Discharge?
  5. What are the Symptoms of HIV Infection and AIDS?
  6. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
  7. 11 Causes of Dyspareunia (Pain During Intercourse)
  8. What is HPV Vaccination (Gardasil 9)
  9. 10 Causes of abnormal Vaginal Lumps and Bumps
  10. An Overview of Gonorrhoea
  11. Genital Warts: The Cauliflower-Like Lumps on the Genitals
  12. Syphilis Symptoms (Painless STD Sores & STD Rashes) 

10 Causes of Abnormal Vaginal Lumps and Bumps

Some women may develop lumps or bumps in the vaginal area sometime during their lives.

The severity of the condition, indicated by these lumps and bumps, can be classified into three categories:

  • Harmless
  • Infection or sexually-transmitted disease
  • Malignancy

For the most part, these lumps or bumps are harmless. The following conditions fall under this group.

1.) Cysts

Cysts can occur anywhere in the body. They are sacs, that range in size, filled with liquid or other substances. In the vaginal area, these cysts are usually benign and painless unless infected. It would feel like a small pebble just underneath the skin of the vulva.

There are two kinds of cysts:

Sebaceous Cysts

Sebaceous cysts result from the blocked hair follicles and ingrown hair when shaving or waxing. Most of these cysts do not require treatment and can be ignored if it does not cause any problems. However, some may need a small incision if they enlarge or become infected.

Bartholin Cysts

When the Bartholin gland (a gland in the vaginal and vulva region) becomes blocked and swells, this will cause a Bartholin cyst to form. The cyst is also harmless unless it becomes infected and turns into an abscess (a swollen area containing pus). In such cases, a trial of antibiotics usually is effective. In some cases, minor surgery may be necessary.

2.) Molluscum Contagiosum

A virus called pox virus causes molluscum contagiosum. It is a skin infection which causes multiple tiny bumps to spread across the area of infected skin. These harmless bumps or raised lesions are pearly white to skin-coloured and will eventually vanish after 1-2 years.
Molluscum contagiosum commonly appears in children and other parts of their bodies. However, it may pose as a sign of an STD when it occurs in adults. It is then advised for these people to get tested for other STDs.
Effective treatment options available to cure this particular type of molluscum contagiosum include:

  • Electrosurgery
  • Freezing (liquid nitrogen)
  • Topical cream

3.) Vestibular Papillomatosis

VP is a skin condition whereby multiple shiny small papules appear over the skin of the inner labia and vaginal opening. Similar to pearly penile papules (PPP) in men, VP is a normal variant of female genitalia; therefore treatment is not necessary.
It should be noted that Vestibular Papillomatosis is commonly mistaken for genital warts because of their similar appearance. Genital wart is a type of Sexually Transmitted Disease (STD). Therefore it is essential to have a correct diagnosis of the condition as a measure to prevent undue stress or prolonged deterioration. Our doctors are able to distinguish between both conditions.

4.) Fordyce Spots

Fordyce spots are enlarged oil glands materialising as small white to yellow lumps over the inner labia. These spots can also appear on the lining of the mouth and occasionally on the penis in men. They are completely painless and harmless.
The condition where lumps and bumps associated with an infection is folliculitis. Other conditions that are STD-related include genital warts, syphilis and herpes.

5.) Folliculitis

Folliculitis is the skin condition where the hair follicles in the labia region become inflamed and infected, causing tender red spots containing pus to surface. The hair follicles become inflamed from bacterial, fungal or even viral infection (e.g. herpes), due to situations that irritate ingrown hair, like shaving or waxing. The treatment is dependent on the type of infection.

6.) Genital Warts

Genital wart is a Sexually Transmitted Disease (STD) caused by the Human Papilloma Virus (HPV), usually, type 6 and 11. Genital warts present as small, skin-coloured cauliflower-like bumps that can either develop into one single lump or more commonly into multiple lumps. Genital warts are highly contagious through skin-to-skin contact.
Depending on the individual, the HPV warts may go away, remain present or spread and increase in amount. Even without developing these warts, the individual can still be a carrier of the HPV virus.
There are HPV vaccinations now available to protect you from certain strains of HPV including type 6 and 11.
(The new Gardasil 9 HPV Vaccination is available in all our clinics in Singapore and Malaysia)

7.) Syphilis

Syphilis is a sexually-transmitted disease that is caused by a bacterial infection. From this, a chancre, a painless sore, will appear in the genital or mouth area. The sore can eventually go away untreated in a few weeks. However, this will lead to the development of severe complications because the infection remains.
Please click here to find out more about syphilis, including treatment options.

8.) Genital Herpes

Genital herpes is a contagious sexually-transmitted disease appearing as multiple painful blisters or ulcers clustered in the genital area. The infection can spread quickly to sexual partners, even with the use of condoms.
Although there is currently no cure for the infection, there are different treatments, like antiviral medications, to prevent and control recurring outbreaks of blisters.

Lumps and bumps can also be a malignant growth, and potentially a sign of cancer.

 

9.) Vaginal Cancer

Vaginal or vulvar cancer can be presented as a lump or bump in the vaginal region. Besides the lumps, this type of cancer is also accompanied by other symptoms, including:

  • Abnormal vaginal bleeding
  • Unusual vaginal discharge
  • Pain during intercourse

In such cases, a pelvic examination and pap smear are done to look for any red flags. A pelvic examination and a pap smear test is done to check for signs of early changes and cancer.
If the results are positive, the doctor will then discuss the next steps for treatment.

10.) Vaginal Melanoma

Melanoma is a type of skin cancer arising from pigmented cells. 2% of melanoma are diagnosed in the vagina or vulva. This cancer is more prevalent in women older than 50.
Vaginal melanoma appears as a pigmented lump in the vaginal area. Other non-specific symptoms include itching, bleeding and pain.

If you are experiencing Abnormal Vaginal Lumps & Bumps, it is highly recommended to visit our female doctors at our Women Clinics as soon as possible.

Take Care!

Other Interesting Reads:

    1. What You Need To Know about HPV, Cervical Cancer, Pap Smear & HPV Vaccination
    2. 11 Causes of Dyspareunia (Pain During Intercourse)
    3. What is HPV Vaccination (Gardasil 9)
    4. 10 Causes of abnormal Vaginal Lumps and Bumps
    5. An Overview of Gonorrhoea
    6. What is the Treatment for Cold Sores? What causes Cold Sores?