The first step in identifying a vulvar lesion is to determine if it is a red or white lesion, according to Dr. Ashley Hill of Florida Hospital. White lesions may be caused by leukoplakia, HPV, squamous cell carcinoma or lichen sclerosus. Red lesions may be a result of lichen planus, dermatitis or melanoma.
Lichen sclerosus may be a cause of a white vulvar lesion, reports Dr. Hill. In this condition, the skin becomes shiny, thin, and white. The lips of the labia may become fused, and the clitoris may shrink as well. Squamous cell hyperplasia causes lesions that are white or off-white, with central sores. Leukoplakia produces a white plaque-like lesion on the vulva, which occurs as a result of vulvar irritation. Vulvar intraepithelial neoplasia may result in both white or red lesions.
A cause of red vulvar lesions is seborrheic dermatitis, adds Dr. Hill. This condition produces brownish or red lesions that are characterized by an oily scaling. Psoriasis can produce red or yellow vulvar lesions. Lichen planus causes sores on mucus membranes, including the vulva. These sores are flat and not raised from the surrounding tissue.
Small freckle-like pigmentation of the vulva may be a result of lentigo, while nevi can cause a range of colored lesions on the vulva, explains Dr. Hill. Carcinomas or melanomas of the vulva are characterized as irregular and may grow outward from the skin of the vulva. These cancers, however, are rare.