Non-sexually related acute genital ulcers in 13 pubertal girls: a clinical and microbiological study

Arch Dermatol. 2009 Jan;145(1):38-45. doi: 10.1001/archdermatol.2008.519.


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.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Adolescent
  • Behcet Syndrome / diagnosis*
  • Behcet Syndrome / pathology
  • Child
  • Diagnosis, Differential
  • Epstein-Barr Virus Infections / diagnosis*
  • Epstein-Barr Virus Infections / pathology
  • Epstein-Barr Virus Infections / transmission
  • Female
  • Humans
  • Ulcer / diagnosis*
  • Ulcer / etiology
  • Ulcer / microbiology
  • Vulvar Diseases / diagnosis*
  • Vulvar Diseases / microbiology
  • Vulvar Diseases / pathology