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

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.