A female patient aged 12 years was referred for asymptomatic vulvar edema of 1 month鈥檚 duration that was previously treated with topical antifungals and corticosteroids with no improvement. She did not report recent travel or sexual relationships. On examination, swelling, erythema, and palpable induration on the labia minora and majora of the vulva were noted. No lymphadenopathy was palpated in the inguinal region (Figure 1A). A 4-mm punch biopsy specimen was obtained for histopathological examination from the right-sided labia majora (Figure 1B).