GENITAL ULCERS IN FEMALE ADOLESCENTS - DIFFERENTIAL DIAGNOSIS

Abstract

Introduction: Genital aphtosis is the most frequent cause of non-infectious vulvar ulceration, usually associated to oral aphtosis and it is always an exclusion diagnosis. We present three cases of genital ulcer in female adolescents, observed in our Dermatology clinic.

Case 1: A 17-year-old-girl, with past history of oral aphtosis, was referred to our clinic with a genital ulcer, fever, asthenia and myalgia.

Case 2: A 13-year-old-girl was observed in our emergency unit with a painful genital ulceration and significant edema of the labia minora.

Case 3: A 14-years-old-girl was observed in our clinic with a painful genital ulcer, fever and sore throat, without oral aphthosis.

In all three cases, sexually transmitted infections, a possible drug reaction and ophthalmologic compromise were excluded. The immunological study and pathergy test were both negative. So far, none of the patients met the criteria of Behçet disease and all of them responded to systemic steroid therapy.

Comments: Nonsexually related acute genital ulcers may arise in patients with Crohn or Behçet disease, "reactive non- sexually related acute genital ulcers "- a subset of complex aphtosis, appears to occur in response to an acute illness rather than in a chronic systemic disease. These cases report the challenging differential diagnosis of acute genital ulcers in young patients, without previous sexual life.

KEYWORDS – Adolescent; Genital Diseases, Female; Ulcer.