A 4-year-old Hispanic girl presented with a 1-year history of a painful lump on the left labium major. The child was developmentally normal. She had no significant past medical history and had received all of her scheduled immunizations. Her parents first noticed a "bump" on the left labium major approximately 1-year before her initial clinic visit. Shortly after appearing, the nodule underwent rapid growth over a 3-month period and turned darker, with a purplish discoloration. The girl initially received treatment from her primary care physician with a topical corticosteroid and oral antibiotic, without improvement.
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