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

Abstract

Reactive nonsexually related acute genital ulcers (RNSRAGU) occur in pubertal girls after an acute systemic infection. We sought to characterize RNSRAGU by reviewing the medical records of patients with this disorder. We searched our medical index database from 1997 to 2007 for RNSRAGU cases. Questionnaires were mailed to identified patients. 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. Retrospective study design, small study size, and 50% questionnaire response rate are limitations. Although rare, RNSRAGU should be considered when genital ulceration follows an acute systemic illness.