CASE DESCRIPTION
We report a healthy 17 year old adolescent who noted flu-like symptoms
and the appearance of painful vulvar lesions associated with pruritus
and dysuria.
Physical examination revealed multiple, painful ulcers located on the
medial side of both labia minora (Figure 1).
A nasopharyngeal swab test was positive for SARS-CoV-2. PCR assay was
negative for Herpes Simplex virus. Tests for Chlamydia
trachomatis and Neisseria gonorrhoeae were negative.Urinalysis revealed no evidence of infection. Serologic tests were
negative for EBV, CMV, syphilis, HIV and Mycoplasma pneumonae .
International Criteria for Behçet´s Disease were applied and this
disease was excluded. The patient was treated with oral
anti-inflammatory drugs and topical lidocaine. 2 weeks later she was
asymptomatic and with complete resolution of the vulvar ulceration.
After all investigation, SARS-CoV-2 infection was considered the trigger
event for the appearance of the acute vulvar ulcers.
LU are rare entities characterized by a sudden onset of necrotic and
painful genital ulcers, which occur mostly in non-sexually active young
women. The mechanism responsible for this lesions is still unknown, but
it is thought that it is associated with an underlying infectious
disease. EBV is noted to be the most cited infectious
etiology.[1,2]
A final diagnosis of LU related to SARS-CoV-2 is only possible after
excluding other causes for these type of vulvar
pathology.[2] With the emergence of the pandemic,
a new infectious etiology should be considered when approaching vulvar
ulcers. Clinical cases like this alert to possible associated conditions
to SARS-CoV-2 infection, leading us to know this new coronavirus better
and better.