An Unusual External Genital Lesion and its Treatment- A Case Report

Lesions around the external genitalia are embarrassing, physically, socially, and emotionally depressing. Patients generally present late for treatment. Here, the authors describe a case of 32 years old female patient, who presented with multiple giant warts-like lesions involving the external genitalia since past 6 months. Any presence of pain, bleeding from the lesion, or alteration in bowel, bladder, or menstrual habits were denied. Lesion posed diagnostic and therapeutic challenges. She underwent resection of the lesion with reconstruction using a bilateral gluteal fasciocutaneous flap and split skin graft with diversion sigmoid colostomy. She further developed anal stricture and subcutaneous fistula, requiring anal dilatation and seton placement. After a brief period of Keigels’s exercises and anal dilatation, she underwent a reversal of sigmoid colostomy. The patient had to undergo staged surgeries to restore near normal external genitalia. This case is an unusual presentation of a genital lesion which was treated with a multidisciplinary team approach to restore her anatomy.