Reactive nonsexually related acute genital ulcers: Review of cases evaluated at Mayo Clinic

• Published in: Journal of the American Academy of Dermatology Vol. 63; no. 1; pp. 44 - 51
• Main Authors: Lehman, Julia S., MD, Bruce, Alison J., MB, ChB, Wetter, David A., MD, Ferguson, Sara B., MD, Rogers, Roy S., MD
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.07.2010; Elsevier
• Subjects: Acute Disease; Adolescent; Analgesics - administration & dosage; Biological and medical sciences; Child; Condylomata Acuminata - diagnosis; Condylomata Acuminata - drug therapy; Condylomata Acuminata - etiology; Dermatology; Female; Gastroenteritis - complications; genital ulcers; Humans; Infection - complications; Influenza, Human - complications; Lipschütz ulcer; Medical sciences; Pharyngitis - complications; Prognosis; Respiratory Tract Infections - complications; Retrospective Studies; Streptococcal Infections - complications; Surveys and Questionnaires; ulcus vulvae acutum; Virus Diseases - complications; Vulvar Diseases - diagnosis; Vulvar Diseases - drug therapy; Vulvar Diseases - etiology; ulcus vulvae acutum; herpes simplex virus; RNSRAGU; genital ulcers; Lipschütz ulcer; EBV; Epstein-Barr virus; HSV; reactive nonsexually related acute genital ulcers; PCR; polymerase chain reaction; Ulcer; Dermatology; Acute; Bibliographic review; Genital system
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2009.08.038

Background Reactive nonsexually related acute genital ulcers (RNSRAGU) occur in pubertal girls after an acute systemic infection. Objective We sought to characterize RNSRAGU by reviewing the medical records of patients with this disorder. Methods We searched our medical index database from 1997 to 2007 for RNSRAGU cases. Questionnaires were mailed to identified patients. Results The study included 10 patients; 5 responded to the questionnaire. The mean age at onset was 11.5 years. Vulvar ulcers were preceded by viral gastroenteritis (n = 3), viral upper respiratory tract infection (n = 3), streptococcal pharyngitis (n = 1), influenza (n = 1), and other nonspecific febrile illnesses (n = 2). Seven patients had oral involvement also; 6 had at least one recurrence; and 3 were hospitalized for pain control. Analgesics and topical corticosteroids were the most common treatments. Ulcerations resolved within several weeks in all patients. Limitations Retrospective study design, small study size, and 50% questionnaire response rate are limitations. Conclusions Although rare, RNSRAGU should be considered when genital ulceration follows an acute systemic illness.