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Peculiar papular eruption on the vulva and inguinal folds
  1. Eman A El-Nabarawy,
  2. Nadia Saleh,
  3. Mona R E Abdel-Halim
  1. Department of Dermatology, Cairo University, Cairo, Egypt
  1. Correspondence to Dr Mona R E Abdel-Halim, Department of Dermatology, Cairo University, Cairo 11562, Egypt; abdelhalimmona{at}

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Clinical question

A 26-year-old woman presented with asymptomatic skin coloured to whitish keratotic papules on the vulva, inguinal folds and inner thighs of 6 years duration. She had no similar lesions elsewhere and no family history. A biopsy was taken from one of the papules.

Review the high-quality, interactive digital Aperio slide at and consider your diagnosis.

What is your diagnosis?

  1. Darrier’s disease

  2. Hailey-Hailey disease

  3. Genital warts

  4. Papular acantholytic dyskeratosis of genitocrural area

  5. Pemphigus vegetans

The correct answer is after the discussion.


Papular acantholytic dyskeratosis (PAD) of the genitocrural area is a peculiar acantholytic dermatosis with dyskeratosis localised to the vulva and inguinal …

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  • Handling editor Iskander Chaudhry.

  • Contributors All authors have contributed to the authorship.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.