Pachydermoperiostosis, which occurs more frequently in men, is a rare entity with distinctive clinical features and an insidious onset.. We report the case of a 30-year-old man with a one-year history of acropachy, arthralgias, hiperhidrosis, and progressive skin thickening of the face and scalp.

The radiological findings were consistent with periostosis and the histopathological analysis from a facial skin biopsy showed a pandermal increase in the thickness and number of collagen bundles.

The pathogenesis of PDP is currently unknown, although an increased secretion of prostaglandin E2 (PGE2), which stimulates the overexpression of vascular endothelial growth factor (VEGF), has been suggested as a major factor. No specific treatment exists; however, in most cases, the disease tends to stabilize over time.

At the beginning of the nineteen-eighties, vulvar vestibular papillomatosis (VVP) was thought to be a human papilloma virus (HPV) disease. Based upon these findings many clinicians have been treating this condition with laser ablation or by topical application of podophyllin or trichloroacetic acid.

Currently, most authors believe that VVP should be considered an anatomical variant of the vestibular mucosa and not HPV related. We present a case of VVP in which there was no histological or molecular evidence of HPV; unnecessary treatment should be avoided.