Pediatric Gynecology: Vulvar Ulcers In Children And Adolescents

What are vulvar ulcers? What are the signs and symptoms? How are they treated? These are just a few of the questions I get asked in the Pediatric Gynecology Clinic at Texas Children’s Hospital. It’s important to stay informed, which is why I’m sharing the answers to these commonly asked questions: 

What are vulvar ulcers? 

Vulvar ulcers may appear in this population. Among adults and adolescents it is estimated that approximately 20 million cases occur annually. Ulcers presenting in children, however, are rare.  Nonetheless a variety of different causes may contribute to these lesions appearing in the genital region. Such causes include viral illness such as Epstein Barr, typically known as the mono virus, and Coxsackie virus, contributing to hand, foot, mouth ulcerations as well as genital ulcers in some cases.  Similar to the previously mentioned viruses, other viruses, such as Herpes Simplex or Varicella Zoster may result in painful genital lesions as well.  Finally, some ulcers in the genital region may be the sign of an underlying medical condition, such as Lupus, or may be associated with certain chronic medical conditions such as inflammatory bowel disease. What are the signs and symptoms? 

Vulvar ulcers are usually a different color than one’s skin tone.  They may be white, red or brown to black in appearance.  When an ulcer forms, it is usually sunken into the skin and may be circular or irregularly shaped.  Some ulcers are painful, while others are painless. 

How are ulcers treated? 

It is important for your child or adolescent to be evaluated by a healthcare provider with experience in dealing with these genital lesions. A thorough history is very helpful for your provider to understand any underlying medical conditions or recent illnesses your child or adolescent may have had.  In addition, an exam and laboratory testing will help the provider determine the possible cause and options for treatment.  Topical steroid creams or ointments can also be useful to decrease inflammation for some types of vulvar ulcers.  Topical anesthetic creams can also be utilized for certain types of painful ulcers as well.  Oral medication may be needed in some cases based on the underlying cause.  Depending on the extent of the ulceration, lesions can take anywhere from a few days to a few weeks to heal. For more information, contact your health provider or contact Texas Children’s Hospital, Pediatric Gynecology Clinic at 832-822-3640 or please visit our website, here.