CASE: Erosive Nodule on the Vulval Skin

A 64-year-old Iranian woman presented with a genital erosive skin lesion that she had noticed from two years ago. On physical examination, a 20 to 25 millimeter purplish lesion was observed on the vulval skin (Figure 1). The indurated lesion showed a small central erosion measuring 3 to 5 mm. Inguinal lymph nodules were not palpable. A skin biopsy specimen was obtained from the eroded lesion (Figure 2).