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Q. I have a black spot on my vulva along with yellowish discharge and frequent urination. Why?

Answered by
Dr. Priyadarshini Tripathy
and medically reviewed by Dr. Lochana
This is a premium question & answer published on Oct 30, 2020 and last reviewed on: May 19, 2021

Hi doctor,

I have yellowish discharge with frequent burning urination at times. I also noticed a black spot in the vulva. I have a history of hemorrhoids. Please help.

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Hi,

Welcome to icliniq.com.

Based on the history and symptoms you have provided, it looks like you have a vaginal infection. It is known as mixed vaginal infection (mixed bacterial vaginosis- a combination of bacterial and fungal vaginosis). There could be some components of STI (sexually transmitted infection) as well if you are sexually active. So the vital thing you need to do is to self-collect a high vaginal swab and send it for culture and sensitivity and STI screening. After collection, please send it to a pathology laboratory for swab microscopy, culture and sensitivity, and STI screening. Based on the results of the swab, I can suggest relevant antibiotics and medicines. Also, you are having frequent urination, which could be due to a urinary tract infection. So it would help if you do a urine routine microscopy, culture, and sensitivity.

Regarding the mole in the vulva you have attached (attachments removed to protect the patient's identity), it could be a regular thing. Let me reassure you that moles are quite common in private parts. However, it essential that you check it often if it grows or changes in appearance or color. In addition, you need to do a biopsy to rule out any abnormal skin lesion if present. Also, if there is a history of melanoma or cancerous mole in your family, you need to be careful and check it often—meanwhile, some preventive measures for you.

1. Drink enough water and fluids.

2. Avoid tight underwear. Instead, wear cotton underwear and bottoms.

3. Avoid detergent, lotions, soaps to the vagina—clean vulva with normal water after urinating. Change undergarments twice a day.

I hope this answers your query and looking forward to hearing from you after the pathology results. Feel free to reach out with any further questions.


Investigations to be done:

High vaginal swab microscopy and culture sensitivity.
Urine microscopy and culture sensitivity.

Hi doctor,

Thanks for the reply.

It is more of a white discharge. So will a swab test be the best option?

#

Hi,

Welcome back to icliniq.com.

You need to do the swab test—also urine routine microscopy, and culture sensitivity tests. The mole looks normal to me. However, you need to check it often. For example, do you have a family history of melanoma or skin cancers? If yes, then you need to check the mole every month (once a month). Also, a skin scraping or biopsy might be required if it grows further or changes in appearance or color. Thank you.

Hi doctor,

Thanks for the reply.

I do not have a family history, but I did get the swab test last month. There was no yeast or any infection. So that is why I am really confused. I was thinking of getting a blood test for my hormones. What to do?

#

Hi,

Welcome back to icliniq.com.

If you do not have a family history, you do not need to check it often. You can check once every three to four months. Moles tend to develop in the dermis and appear or evolve or disappear on their own. You should be reassured regarding the same. See if you have yellowish discharge. Hormonal tests will not help you to reach a diagnosis. Hormonal tests are done when cycles are irregular. As you have discharge and painful urination, you need to do a swab and urine test because they can only diagnose if a pathogen is growing locally and causing infection and discharge. Another thing, if you are sexually active, you could do an STI screen (STI polymerase chain reaction) on first urine. At times STIs also cause such kind of discharge. If time permits, you could visit some doctor or nurse to do a per speculum examination and a Pap smear. You might be having an early pelvic inflammatory disease. So you can do an ultrasound of the pelvis. Hormonal tests are not required. If you are keen on doing any blood investigation, you can do a complete blood count test and CRP (c-reactive protein), which can also show if there is an infection.

Hi doctor,

Thanks for the reply.

I will look into it. This is very discomforting. I did get a swab test and culture, but I will try again. Thank you.

#

Hi,

Welcome back to icliniq.com.

No worries. At times swabs do not pick up the pathogens if the infection just started at a very early stage, or the swab collection was inadequate. So we need to repeat it at intervals. Also, the correct technique of collection is essential. So take care and stay safe.


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