The patient reported itching and burning. The flattening on the right side could be a normal variant but could be related to early lichenoid changes. The entire exam must be completed to come to a diagnosis. In the absence of yeast, biopsy could be considered.

Asymmetry of the labia minora in a young woman with both condyloma and vulvar inflammation.

The patient’s tissue certainly looks normal in color, texture, and integrity. The difference in size between the left and right labia minora can be attributed to normal variance. However, since childhood lichen sclerosus may occur and may cause loss of normal anatomy, it is good to keep that in mind when the patient is seen for follow up visits.