Snapshot A 45-year-old female finally visits her gynecologist due to her embarrassment of her genital growths. She complains of large bumps on the vulva and groin area for the past year. She denies dyspareunia, vulvar pruritus, change in vaginal discharge, and dysuria. She was sexually active with numerous sexual partners, the last encounter being about 1 year ago. She has an IUD and her last partner used condoms infrequently. Physical exam reveals multiple large flesh colored pedunculated papules on the vulva and inguinal region and medial thigh. A Pap smear and excisional biopsy were carried out. Introduction Allows for replication and cellular division Differential Condyloma lata of secondary syphilis differentiating factor condyloma lata are more flat-topped Molluscum contagiosum differentiating factor have central dimpling and often in immunocompromised individuals Genital herpes differentiating factor painful ulcerating lesions Complications Cervical cancer Anal cancer Head and neck cancer Penile cancer