Non–Sexually Related Acute Genital Ulcers in 13 Pubertal Girls: A Clinical and Microbiological Study

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Abstract

Objective:

To describe the clinical and microbiological features of acute genital ulcers (AGU), which have been reported in virgin adolescents, predominantly in girls.

Design:

Descriptive study. We collected data on the clinical features, sexual history, blood cell count, biochemistry, microbiological workup, and 1-year follow-up.

Setting:

Departments of dermatology of 3 university hospitals in Paris.

Patients:

Thirteen immunocompetent female patients with a first flare of non–sexually transmitted AGU.

Main Outcome Measures:

Clinical and microbiological data, using a standardized form.

Results:

Mean age was 16.6 years (range, 11–19 years). Eleven patients denied previous sexual contact. A fever or flulike symptoms preceded AGU in 10 of the 13 patients (77%), with a mean delay of 3.8 days before the AGU onset (range, 0–10 days). The genital ulcers were bilateral in 10 patients. The final diagnosis was Epstein-Barr virus primary infection in 4 patients (31%) and Behçet disease in 1 patient (8%). No other infectious agents were detected in this series.

Conclusions:

We recommend serologic testing for Epstein-Barr virus with IgM antibodies to viral capsid antigens in non–sexually related AGU in immunocompetent patients. Further microbiological studies are required to identify other causative agents.

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