300 Obstetrics and Gynecology Board Review •••
❍ What is the duration of treatment of condyloma with 5-FU for vulvar and vaginal lesions?
Two treatments of 5 to 7 days of consecutive nightly applications.
❍ Which treatment of vaginal condylomas is contraindicated in pregnancy?
Podophyllin.
❍ What are the risk factors associated with vaginal condylomas and vaginal delivery?
Trauma and heavy bleeding during delivery, and, infrequently, laryngeal papillomas in the newborn.
❍ What is the most common cystic lesion of the vulva?
Epidermal inclusion cyst.
❍ What is an epidermal inclusion cyst?
A cyst in which the cyst wall contains normal epidermis that produces keratin; most commonly these cysts arise
from pilosebaceous ducts that have become occluded. A less common cause is traumatically buried skin fragments.
❍ What is the treatment of inclusion cysts?
They need no treatment unless infected or for cosmetic reasons. If infected, they can be incised and drained after
antibiotic treatment is instituted.
❍ What is the most common site of an inclusion cyst?
The site of a previous laceration or episiotomy scar in the vagina or in the labia majora, especially the anterior half.
❍ What is a syringoma?
A benign adenoma of the eccrine sweat gland, found most often around the eyelids and less commonly on the
vulva, chest, or abdomen.
❍ How are Bartholin duct abscesses treated?
A small stab wound is made in the abscess and a Word catheter is inserted and left in place for 4 to 6 weeks to
allow epithelialization of a tract and permanent opening of the gland.
❍ How are recurrent Bartholin duct cysts treated?
Marsupialization.
❍ How are Bartholin duct cysts treated differently in postmenopausal women?
Malignancy must be ruled out; all or part of the Bartholin duct cyst should be removed for histologic evaluation
when recurrent/persistent.
❍ What are the vulvovaginal cysts of embryonic origin?
Mesonephric cysts, paramesonephric cysts, and urogenital sinus mucus cysts.
❍ What is a Skene duct cyst?
Cystic dilatation of an occluded paraurethral duct, usually associated with infection in the duct.