A 33-year-old woman with burning and blistering of perivaginal tissue following sexual intercourse

Abstract

History of Present Illness A 33-year-old woman who had been having sexual intercourse with her fiance for 6 months without discomfort subsequently began to experience adverse reactions. Symptoms included redness, swelling, pain, and burning of the vulva and within her vagina. The onset of symptoms was several hours after sexual intercourse and was accompanied by blistering and erosion of perivaginal tissue and a slightly bloody vaginal discharge. She denied symptoms of localized or generalized pruritus, urticaria, or respiratory or gastrointestinal distress. These episodes, numbering 2 or 3 before seeking physician assistance and totaling 4 or 5 in all, were not noted to progress in severity and occurred only after coitus. The signs and symptoms resolved spontaneously without treatment during a 6to 7-day period. The patient denied adverse reactions on other areas of skin or oral mucosa exposed to semen. She has a monogamous relationship with her fiance and never has had adverse reactions with prior sexual partners. Condoms were used. She denied the use of tampons and intravaginal medications or devices, including sponges and diaphragms. The patient was first evaluated by her gynecologist. Pelvic examination performed during an episode was difficult secondary to pain and discomfort. Latex examination gloves were used. She was treated empirically with antiherpetic medication and later with topical steroids and antibiotics. Despite these treatments, the patient continued to have adverse reactions after sexual intercourse with her fiance. Current Medications The patient was not taking any medications at the time of presentation.