Reactive non-sexually related acute genital ulcers associated with COVID-19

Jill M Krapf; Rachel K Casey; Andrew T Goldstein

doi:10.1136/bcr-2021-242653

Reactive non-sexually related acute genital ulcers associated with COVID-19

BMJ Case Rep. 2021 May 5;14(5):e242653. doi: 10.1136/bcr-2021-242653.

Authors

Jill M Krapf^{1

2}, Rachel K Casey³, Andrew T Goldstein^{4

2}

Affiliations

¹ Gynecology, Center for Vulvovaginal Disorders, Washington, DC, USA jillkrapf@gmail.com.
² Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA.
³ Pediatric Specialists of Virginia, Inova Fairfax Medical Campus, Department of Obstetrics and Gynecology, Fairfax, Virginia, USA.
⁴ Gynecology, Center for Vulvovaginal Disorders, Washington, DC, USA.

Abstract

Acute genital ulcers (AGU), known as Lipschütz ulcers, are painful vulvar ulcers typically affecting non-sexually active girls and women. AGU have been associated with viral infections, namely, Epstein-Barr virus (EBV). Here, we describe a case of AGU in the setting of SARS-CoV-2 in a non-sexually active adolescent girl hospitalised for pain control and urinary retention, who failed a course of oral corticosteroids and then improved with colchicine. Testing for herpes simplex virus, EBV and Behcet's syndrome were all negative. Testing for SARS-CoV-2 was positive. COVID-19 increases cytokines such as tumour necrosis factor alpha, which has been shown to affect endothelial cell adhesion and neutrophil chemotaxis, leading to aphthosis.

Keywords: dermatology; genital ulcers; infectious diseases; vulvovaginal disorders.

Publication types

Case Reports

MeSH terms

Adolescent
COVID-19*
Epstein-Barr Virus Infections* / complications
Epstein-Barr Virus Infections* / diagnosis
Female
Genitalia
Herpesvirus 4, Human
Humans
SARS-CoV-2
Ulcer / diagnosis