Vulvar pathology comprise of a wide variety of lesions. Ectopic mammary tissue can be seen.

Presence of toker cells which are CK7 positive should not be mistaken for melanoma. Melanoma in the vulva can be cause by PPV 38 and HPV3.

Infections like granuloma inguinale, behcet disease, syphilis, chlamydia should be considered in the differentials of inflammation.

Vulvar intraepithelial neoplasia (VIN) like squamous intraepithelial lesions of the cervix is categorized into VIN1, VIN2 and VIN3. In addition, there is the classic VIN which is the warty type and driven by p16 and the differentaited VINis the keratinizing type and driven by p53.

Mesenchymal lesions of the vulva include leimyosarcoma, aggressive angiomyxoma with cellularity around proliferating blood vessels, angiomyofibroblastoma comprising of alternating hypo and hyper-cellular areas and cellular angiofibroma with thick walled  blood vessels.