Non–Sexually Related Acute Genital Ulcers in 13 Pubertal Girls

Abstract

To describe the clinical and microbiological features of acute genital ulcers (AGU), which have been reported in virgin adolescents, predominantly in girls. Descriptive study. We collected data on the clinical features, sexual history, blood cell count, biochemistry, microbiological workup, and 1-year follow-up. Departments of dermatology of 3 university hospitals in Paris. Patients Thirteen immunocompetent female patients with a first flare of non-sexually transmitted AGU. Clinical and microbiological data, using a standardized form. 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. 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.