Seasonal virus may be cause of vulvar ulcers: reported in pediatric, adolescent patients. (Retrospective Review).

MIAMI BEACH -- Unexplained vulvar ulcers in pediatric and adolescent patients may be caused by an unidentified seasonal virus, physicians reported at the annual meeting of the North American Society for Pediatric and Adolescent Gynecology.

One of the physicians, Dr. Helen Deitch, described a retrospective review of six pubertal but premenarchal patients who presented in the fall and winter months with extremely painful labial and vulvar lesions. The ulcers lasted for 10 days to 3 weeks and in some cases caused dysuria.

"It is very important for physicians to be aware of this and to recognize this possibility, because understandably both patients and their parents can be very upset about these ulcers," said Dr. Deitch, a gynecologic fellow at Cincinnati Children's Hospital Medical Center.

The ulcers were treated symptomatically with lidocaine jelly, oral analgesics, sitz baths, and sucralfate. In some patients, antibiotics were prescribed to treat superimposed cellulitis.

All six patients had fever, two had abdominal pain, two had nausea, one had cough, one had sore throat, and one had a torso rash. One patient had recurrence of the ulcers. None of the patients claimed to be sexually active, and tests were negative for herpes simplex virus, Epstein-Barr virus, and rapid plasma reagin.

"Our theory is that this is a viral syndrome, which is self-limiting and generally without recurrence, and this is supported by the presence of other systemic symptoms and its seasonality," she said.

Her group is planning a prospective study in which they will draw both acute and convalescent titers with the aim of identifying the virus. "We have yet to decide what lab evaluations we will be running on the stored serum," she said in an interview