34-year-old woman comes to the office for evaluation of vulvar lesions that have worsened over the past 3 months

34-year-old woman comes to the office for evaluation of vulvar lesions that have worsened over the past 3 months. She has had 2 sexual partners in the last year. Medical history includes genital infection with herpes simplex virus diagnosed at age 23; when she was 25, her sexual partner was diagnosed with syphilis Cervical cancer screening last year revealed atypical squamous cells of undetermined significance, with negative testing for high-risk human papillomavirus. The patient smokes cigarettes but does not use alcohol or illicit drugs Examination reveals multiple nontender, fleshy, verrucous growths clustered at the vestibule of the vulva and over the labia majora A few lesions are friable and bleed on manipulation . The remainder of the physical examination is normal. Which of the following is the most likely diagnosis in this patient?

  • QA Condylomata acuminata
  • 0 B. Condylomata !ala
  • 0 C. Genital herpes
  • 0 D. Lichen planus
  • 0 E. Lichen sclerosus
  • 0 F Molluscum contagiosum
  • 0 G. Vulvar cancer

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