Genital ulcers associated with Epstein-Barr virus infection (ulcus vulvae acutum)

Acta Derm Venereol. 2011 Jan;91(1):55-9. doi: 10.2340/00015555-0979.


Epstein-Barr virus (EBV) infection may rarely be associated with genital ulcers (ulcus vulvae acutum), a very painful manifestation. The aetiopathogenesis of the disease is not fully understood. We describe here a case of an adolescent virgin with multiple, deep genital ulcers associated with acute infectious mononucleosis. The diagnosis was supported by the clinical symptoms, atypical lymphocytosis, elevated circulating levels of liver enzymes, positive EBV serology, and the detection of EBV in a swab sample and a biopsy specimen by PCR. The virus could not be detected by immunohistochemistry or in situ hybridization. After a short course of methylprednisolone as a supportive treatment, the ulcers healed within one month. No relapse occurred during the 2-year follow-up. Available data relating to the aetiopathogenesis of this condition are reviewed, and we speculate that it may have been caused by percutaneous autoinoculation through cervicovaginal fluid.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Epstein-Barr Virus Infections / complications
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Infectious Mononucleosis / complications*
  • Methylprednisolone / therapeutic use
  • Ulcer / complications
  • Ulcer / drug therapy
  • Ulcer / pathology
  • Ulcer / virology*
  • Vulvar Diseases / complications
  • Vulvar Diseases / drug therapy
  • Vulvar Diseases / pathology
  • Vulvar Diseases / virology*


  • Glucocorticoids
  • Methylprednisolone