{"id":7939,"date":"2020-04-26T11:55:32","date_gmt":"2020-04-26T14:55:32","guid":{"rendered":"https:\/\/doctorhoogstra.com\/es\/diagnostico-diferencial-de-ulceras-vulvares\/"},"modified":"2020-10-30T07:36:44","modified_gmt":"2020-10-30T10:36:44","slug":"differential-diagnosis-of-vulvar-ulcers","status":"publish","type":"wiki","link":"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/","title":{"rendered":"Differential diagnosis of vulvar ulcers"},"content":{"rendered":"<p><\/p><div id=\"ez-toc-container\" class=\"ez-toc-v2_0_88 counter-hierarchy ez-toc-counter ez-toc-grey ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<p class=\"ez-toc-title\" style=\"cursor:inherit\">Contents<\/p>\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewbox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewbox=\"0 0 24 24\" version=\"1.2\" baseprofile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 eztoc-toggle-hide-by-default' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Que-son-vulvares-ulceras\" >What are vulvar ulcers?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#%C2%BFQuien-contrae-ulceras-vulvares\" >Who gets vulvar ulcers?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#%C2%BFQue-causa-las-ulceras-vulvares\" >What causes vulvar ulcers?<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Causas-infecciosas-de-ulceras-vulvares\" >Infectious causes of vulvar ulcers<\/a><ul class='ez-toc-list-level-4' ><li class='ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Infecciones-de-transmision-sexual\" >Sexually transmitted infections<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-6\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Infecciones-de-transmision-no-sexual\" >Non-sexually transmitted infections<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-7\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Causas-no-infecciosas-de-ulceras-vulvares\" >Non-infectious causes of vulvar ulcers<\/a><ul class='ez-toc-list-level-4' ><li class='ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-8\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Aftosis-vulvar\" >Vulvar aphtosis<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-9\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Enfermedades-inflamatorias\" >Inflammatory diseases<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-10\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Enfermedades-ampollas\" >Blistering diseases<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-4'><a class=\"ez-toc-link ez-toc-heading-11\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Malignidad\" >Malignancy<\/a><\/li><\/ul><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-12\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#%C2%BFCuales-son-las-caracteristicas-clinicas-de-las-ulceras-vulvares\" >What are the clinical characteristics of vulvar ulcers?<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-13\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Virus-del-herpes-simple\" >Herpes simplex virus<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-14\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Chancroide\" >Chancroid<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-15\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Chancro-primario-de-sifilis\" >Syphilis primary chancre<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-16\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Linfogranuloma-venereo\" >Venereal lymphogranuloma<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-17\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Granuloma-inguinal\" >Inguinal granuloma<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-18\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Aftosis\" >Aphthosis<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-19\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#enfermedad-de-Crohn\" >Crohn&#039;s disease<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-20\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Pioderma-gangrenoso\" >Gangrenous pyoderma<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-21\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Hidradenitis-supurativa\" >Hidradenitis suppurativa<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-22\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Carcinoma-de-celulas-escamosas\" >Squamous cell carcinoma<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-23\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#%C2%BFComo-se-diagnostican-las-ulceras-vulvares\" >How are vulvar ulcers diagnosed?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-24\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#%C2%BFCual-es-el-tratamiento-para-la-ulceracion-vulvar\" >What is the treatment for vulvar ulceration?<\/a><ul class='ez-toc-list-level-3' ><li class='ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-25\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Medidas-generales\" >General measures<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-3'><a class=\"ez-toc-link ez-toc-heading-26\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#Tratamiento-especifico\" >Specific treatment<\/a><\/li><\/ul><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-27\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/diagnostico-diferencial-de-ulceras-vulvares\/#%C2%BFCual-es-el-resultado-de-la-ulceracion-vulvar\" >What is the result of vulvar ulceration?<\/a><\/li><\/ul><\/nav><\/div>\n\n<section class=\"textBlock\">\n<h2><span class=\"ez-toc-section\" id=\"Que-son-vulvares-ulceras\"><\/span>What are vulvars <span class=\"term\" data-term-id=\"1279\">ulcers<\/span>?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Vulvar ulcers (sores or <span class=\"term\" data-term-id=\"536\">erosions<\/span>) are breaks in the skin or <span class=\"term\" data-term-id=\"188\">mucous<\/span> membranes of the <span class=\"term\" data-term-id=\"1004\">vulva<\/span> that expose the underlying tissue. They can cause itching or pain. They can produce a <span class=\"term\" data-term-id=\"840\">download<\/span>. Alternatively, they can be completely <span class=\"term\" data-term-id=\"731\">asymptomatic<\/span>.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQuien-contrae-ulceras-vulvares\"><\/span>Who gets vulvar ulcers?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Any woman or girl can develop vulvar ulcers, regardless of age, region, race, ethnicity, sexual preference, or <span class=\"term\" data-term-id=\"721\">Socioeconomic status<\/span> (depending on the cause of the <span class=\"term\" data-term-id=\"290\">ulcer<\/span>)<\/p>\n<p>The global <span class=\"term\" data-term-id=\"578\">incidence<\/span> of genital ulcer disease is estimated at more than 20 million cases a year.<\/p>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFQue-causa-las-ulceras-vulvares\"><\/span>What causes vulvar ulcers?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Vulvar ulcers are the result of tissue death from <span class=\"term\" data-term-id=\"489\">focal<\/span> <span class=\"term\" data-term-id=\"148\">inflammation<\/span>. They can be caused by infectious or non-infectious causes.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Causas-infecciosas-de-ulceras-vulvares\"><\/span>Infectious causes of vulvar ulcers<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Infectious causes of vulvar ulcers include sexually transmitted infections (STIs) and non-sexually transmitted infections.<\/p>\n<h4><span class=\"ez-toc-section\" id=\"Infecciones-de-transmision-sexual\"><\/span>Sexually transmitted infections<span class=\"ez-toc-section-end\"><\/span><\/h4>\n<p>STIs that can cause vulvar ulcers can include:<\/p>\n<ul>\n<li>\n<p>Genital herpes: caused by the herpes simplex virus (HSV); HSV 2 is more common than HSV I<\/li>\n<li>\n<span class=\"term\" data-term-id=\"949\">Primary<\/span> syphilis - caused by <em>Treponema pallidum<\/em>\n<\/li>\n<li>\n<p>Chancroid - caused by <em>Haemophilus ducreyi<\/em>\n<\/li>\n<li>\n<p>Lymphogranuloma venereum (LGV) - caused by<em> Chlamydia trachomatis<\/em> L1 and L2 serotypes<\/li>\n<li>\n<span class=\"term\" data-term-id=\"113\">Granuloma<\/span> inguinal (donovanosis) - caused by<em> Klebsiella granulomatis<\/em>.<\/li>\n<\/ul>\n<h4><span class=\"ez-toc-section\" id=\"Infecciones-de-transmision-no-sexual\"><\/span>Non-sexually transmitted infections<span class=\"ez-toc-section-end\"><\/span><\/h4>\n<p>Viral infections that can cause vulvar ulcers include:<\/p>\n<ul>\n<li>\n<p>Herpes simplex via <span class=\"term\" data-term-id=\"495\">autoinoculation<\/span>\n<\/li>\n<li>\n<p>Epstein-Barr virus (EBV)<\/li>\n<li>\n<p>Cytomegalovirus (CMV)  <\/li>\n<li>\n<p>Chicken pox or <a class=\"wpil_keyword_link\" href=\"https:\/\/doctorhoogstra.com\/en\/wiki\/infeccion-de-herpes\/\" title=\"Herpes zoster\">Herpes zoster<\/a> (shingles) \u2013 caused by the varicella-zoster virus (VZV).<\/li>\n<\/ul>\n<p><span class=\"term\" data-term-id=\"937\">Bacterial<\/span> Infections that can cause vulvar ulcers include:<\/p>\n<ul>\n<li>Group A streptococcal infections\n<\/li>\n<li>\n<p>Mycoplasma <\/li>\n<\/ul>\n<p>The most common fungus. <span class=\"term\" data-term-id=\"145\">infection<\/span> which can cause vulvar ulcers is <span class=\"term\" data-term-id=\"1003\">vulvovaginal<\/span> yeast infection.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Causas-no-infecciosas-de-ulceras-vulvares\"><\/span>Non-infectious causes of vulvar ulcers<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Non-infectious causes of <span class=\"term\" data-term-id=\"1278\">ulceration<\/span> of the vulva include aphtosis, <span class=\"term\" data-term-id=\"490\">inflammatory<\/span> malignant diseases, blisters and tumors.<\/p>\n<h4><span class=\"ez-toc-section\" id=\"Aftosis-vulvar\"><\/span>Vulvar aphtosis<span class=\"ez-toc-section-end\"><\/span><\/h4>\n<p>After herpes simplex, aphtosis or sexually not acquired genital ulceration is the second most common cause of vulvar ulcers, with the highest rates occurring in Caucasians and adolescents.<\/p>\n<p>Other names for vulvar aphtosis include vulvar aphthous ulcers, Lipsch\u00fctz ulcer, Mikulicz ulcer, Sutton ulcer, and ulcus vulvae acutum. Vulvar aphtosis is commonly associated with oral ulceration.<\/p>\n<p>Aphthous vulvar ulcers may be reactive after infection (such as infectious mononucleosis) or <span class=\"term\" data-term-id=\"1365\">trauma<\/span> - or be related to an underlying <span class=\"term\" data-term-id=\"380\">systemic<\/span> disease like:<\/p>\n<ul>\n<li>Crohn&#039;s disease<\/li>\n<li>Beh\u00e7et&#039;s disease<\/li>\n<li>\n<p>Gluten enteropathy (celiac disease)<\/li>\n<li>\n<p>Systemic lupus erythematosus  <\/li>\n<li>Human immunodeficiency virus (<span class=\"term\" data-term-id=\"127\">HIV<\/span>) infection<\/li>\n<li>\n<p>Myeloproliferative disorder.<\/li>\n<\/ul>\n<h4><span class=\"ez-toc-section\" id=\"Enfermedades-inflamatorias\"><\/span>Inflammatory diseases<span class=\"ez-toc-section-end\"><\/span><\/h4>\n<p>A range of <span class=\"term\" data-term-id=\"691\">autoimmune<\/span> disease and <span class=\"term\" data-term-id=\"1251\">autoinflammatory<\/span> Diseases can present with vulvar ulceration. These include:<\/p>\n<ul>\n<li>\n<span class=\"term\" data-term-id=\"53\">Dermatitis<\/span> - due to scratching or secondary infection<\/li>\n<li><span class=\"term\" data-term-id=\"537\">Erosive<\/span> lichen planus<\/li>\n<li>Lichen sclerosus<\/li>\n<li>\n<p>Fixed drug <span class=\"term\" data-term-id=\"704\">eruption<\/span> - most commonly caused by non-steroids <span class=\"term\" data-term-id=\"1413\">anti-inflammatory<\/span> drugs (<span class=\"term\" data-term-id=\"635\">NSAID<\/span>), paracetamol, sulfonamides and tetracyclines\n<\/li>\n<li>Stevens - Johnson <span class=\"term\" data-term-id=\"350\">syndrome<\/span> (SJS) \/ <span class=\"term\" data-term-id=\"1159\">toxic<\/span> <span class=\"term\" data-term-id=\"846\">epidermal<\/span> necrolysis (TEN)<\/li>\n<li>\n<p>Crohn&#039;s disease: usually presents with <span class=\"term\" data-term-id=\"321\">linear<\/span> ulcers<\/li>\n<li>\n<p>Systemic lupus erythematosus\n<\/li>\n<li>Darier&#039;s disease<\/li>\n<li><span class=\"term\" data-term-id=\"1626\">Pyoderma<\/span> gangrenous<\/li>\n<li>\n<p>Hidradenitis suppurativa.<\/li>\n<\/ul>\n<h4><span class=\"ez-toc-section\" id=\"Enfermedades-ampollas\"><\/span>Blistering diseases<span class=\"ez-toc-section-end\"><\/span><\/h4>\n<p>Autoimmune blistering skin conditions can present with erosions and ulcers. The vulva is rarely the only affected site. <\/p>\n<ul>\n<li>\n<p>Pemphigus vulgaris is an erosive disease that leaves no scars. Oral <span class=\"term\" data-term-id=\"189\">mucous membrane<\/span>, vulva, anus, and scalp are common sites of involvement.<\/li>\n<li>\n<span class=\"term\" data-term-id=\"1485\">Mucous membrane<\/span> pemphigoid<span class=\"term\" data-term-id=\"36\">scar<\/span> pemphigoid) causes <span class=\"term\" data-term-id=\"319\">chronic<\/span> ulceration and scarring. It usually affects more than one. <span class=\"term\" data-term-id=\"1018\">mucous membrane<\/span> site that includes the vulva, anus, mouth, eyes, nostrils and can also affect the scalp.<\/li>\n<li>\n<span class=\"term\" data-term-id=\"498\">Bullous<\/span> pemphigoid produces time <span class=\"term\" data-term-id=\"499\">bullas<\/span> (fluid-filled blisters) on normal skin or, more often, <span class=\"term\" data-term-id=\"492\">eczematous<\/span> or <span class=\"term\" data-term-id=\"493\">Urticated<\/span> <span class=\"term\" data-term-id=\"368\">plates<\/span>. It rarely involves mucous surfaces, but is common in body folds (i.e., the back of the knees, the inside of the armpits, elbows, and groin) in older people.<\/li>\n<li>\n<span class=\"term\" data-term-id=\"90\">Erythema<\/span> multiform is a <span class=\"term\" data-term-id=\"349\">acute<\/span> or <span class=\"term\" data-term-id=\"805\">recurrent<\/span> reactive condition Erythema multiforme major can cause very painful vulvar ulceration, generally associated with oral ulceration and target lesions in the <span class=\"term\" data-term-id=\"68\">distal<\/span> extremities<\/li>\n<\/ul>\n<p><span class=\"term\" data-term-id=\"558\">Genetic<\/span> diseases can present with chronic ulceration of the vulva and <span class=\"term\" data-term-id=\"1192\">perianal<\/span> skin.<\/p>\n<ul>\n<li>\n<p>Epidermolysis bullosa is a group of disorders that present with blisters in childhood. Subtypes of epidermolysis bullosa that can cause vulvar ulcers include junctional epidermolysis bullosa and dystrophic epidermolysis bullosa.<\/li>\n<li>\n<span class=\"term\" data-term-id=\"849\">Family<\/span> <span class=\"term\" data-term-id=\"22\">benign<\/span> Chronic pemphigus (Hailey-Hailey disease) occurs in early adulthood with chronic disease, <span class=\"term\" data-term-id=\"279\">symmetrical<\/span> <span class=\"term\" data-term-id=\"173\">maceration<\/span> and erosions of the vulva, perianal skin, and others <span class=\"term\" data-term-id=\"970\">push-ups<\/span>, even under the breasts and neck.<\/li>\n<\/ul>\n<h4><span class=\"ez-toc-section\" id=\"Malignidad\"><\/span><span class=\"term\" data-term-id=\"1742\">Malignancy<\/span><span class=\"ez-toc-section-end\"><\/span><\/h4>\n<p>Malignant tumors that can cause ulceration of the vulva include:<\/p>\n<ul>\n<li><span class=\"term\" data-term-id=\"270\">Scaly<\/span> cell <span class=\"term\" data-term-id=\"32\">carcinoma<\/span><\/li>\n<li>\n<p>Intraepithelial vulval <span class=\"term\" data-term-id=\"1263\">neoplasm<\/span> (vulvar squamous intraepithelial lesions).<\/li>\n<\/ul>\n<p>Less often, the following may also cause ulceration of the vulva:<\/p>\n<ul>\n<li>Extramammary Paget&#039;s disease<\/li>\n<li><span class=\"term\" data-term-id=\"831\">Basal<\/span> cell carcinoma<\/li>\n<li>Cell B <span class=\"term\" data-term-id=\"976\">lymphoma<\/span><\/li>\n<li><span class=\"term\" data-term-id=\"613\">Leukemia<\/span> <span class=\"term\" data-term-id=\"48\">skin<\/span><\/li>\n<li>\n<p>Langerhans cell <span class=\"term\" data-term-id=\"1346\">histiocytosis<\/span> (histiocytosis X).<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCuales-son-las-caracteristicas-clinicas-de-las-ulceras-vulvares\"><\/span>What are the clinical characteristics of vulvar ulcers? <span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Vulvar ulcers are often <span class=\"term\" data-term-id=\"116\">grouped<\/span> for the following characteristics:<\/p>\n<ul>\n<li>Single or multiple<\/li>\n<li>Painful or painless<\/li>\n<li>Ulcer evolution (i.e. initial appearance and progression)<\/li>\n<ul>\n<li>Ulceration preceded by dryness, <span class=\"term\" data-term-id=\"384\">climbing<\/span>and <span class=\"term\" data-term-id=\"501\">excoriations<\/span> suggests dermatitis\n<\/li>\n<\/ul>\n<li>Frequency of episodes<\/li>\n<ul>\n<li>Recurrent ulcers may suggest HSV, Beh\u00e7et&#039;s disease, fixed drug eruption\n<\/li>\n<\/ul>\n<li>Associated signs or symptoms<\/li>\n<ul>\n<li>\n<span class=\"term\" data-term-id=\"502\">Inguinal<\/span> <span class=\"term\" data-term-id=\"503\">lymphadenopathy<\/span> indicates probable infection<\/li>\n<li>\n<span class=\"term\" data-term-id=\"505\">Uveitis<\/span>, <span class=\"term\" data-term-id=\"1578\">arthritis<\/span> and \/ or a family history of these may suggest Beh\u00e7et&#039;s disease\n<\/li>\n<li>Exposure to new medications may indicate a fixed drug eruption\n<\/li>\n<li>Oral mucosa involvement occurs in aphtosis or erosive lichen planus\n<\/li>\n<li>\n<span class=\"term\" data-term-id=\"506\">Dysuria<\/span> may be due to the location of the ulcer or sexual transmission <span class=\"term\" data-term-id=\"507\">urethritis<\/span>\n<\/li>\n<li>Constitutional symptoms can occur in herpes simplex, secondary syphilis, LGV, or systemic lupus erythematosus.<\/li>\n<\/ul>\n<\/ul>\n<p>The typical characteristics of various presentations with vulvar ulceration are described below.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Virus-del-herpes-simple\"><\/span>Herpes simplex virus<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>Clusters of small blisters. <span class=\"term\" data-term-id=\"386\">get together<\/span> and it opens to form painful (or itchy) sores with a red base.<\/li>\n<li>Ulcers may appear on the vulva, cervix, vagina, <span class=\"term\" data-term-id=\"889\">perineum<\/span>, legs or buttocks.<\/li>\n<li>\n<span class=\"term\" data-term-id=\"1395\">Atypical<\/span>Extensive or long-lasting disease affects immunosuppressed patients.<\/li>\n<li>Big and tender jock <span class=\"term\" data-term-id=\"1775\">lymph nodes<\/span> and &#039;flu-like symptoms occur with a primary infection.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Chancroide\"><\/span>Chancroid<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>Single or multiple, <span class=\"term\" data-term-id=\"292\">unilateral<\/span>painful <span class=\"term\" data-term-id=\"366\">papules<\/span> become <span class=\"term\" data-term-id=\"792\">pustular<\/span> and ulcerate<\/li>\n<li>The ulcers show irregular torn edges with gray or yellow discharge.<\/li>\n<li>As the disease progresses, approximately 50% of patients develop sensitive inguinal lymph nodes that can rupture and cry.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Chancro-primario-de-sifilis\"><\/span>Syphilis primary chancre<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>There is a single painless ulcer with a clean base and firm raised edges.<\/li>\n<li>It is often associated with large, non-sensitive inguinal lymph nodes.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Linfogranuloma-venereo\"><\/span>Venereal lymphogranuloma<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>There is a single, transient and painless ulcer.<\/li>\n<li>It is often associated with urethritis and is followed by sensitive inguinal lymph nodes weeks later.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Granuloma-inguinal\"><\/span>Inguinal granuloma<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>There are single or multiple, chronic, red, <span class=\"term\" data-term-id=\"1741\">indurated<\/span>Painless, ulcers that bleed easily.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Aftosis\"><\/span>Aphthosis<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>There are intensely painful stabbing ulcers, which are often <span class=\"term\" data-term-id=\"23\">bilateral<\/span>, with a yellow-white base and red edges.<\/li>\n<li>There is associated lip swelling, severe pain and dysuria, and sometimes large, tender inguinal lymph nodes.<\/li>\n<li>Recurrent episodes of ulceration of the genital and oral mucosa associated with uveitis suggest Beh\u00e7et&#039;s disease.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"enfermedad-de-Crohn\"><\/span>Crohn&#039;s disease<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>Mixed inflammatory lesions, <span class=\"term\" data-term-id=\"801\">fissures<\/span>, and there are &quot;knife cut&quot; ulcers of varying severity.<\/li>\n<li>Deeper ulcers can progress to <span class=\"term\" data-term-id=\"509\">fistulas<\/span>; more commonly, in perianal or rectovaginal sites.<\/li>\n<li>Painless vulvar marking <span class=\"term\" data-term-id=\"201\">edema<\/span> it can happen.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Pioderma-gangrenoso\"><\/span>Gangrenous pyoderma<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>A tender inflammatory <span class=\"term\" data-term-id=\"251\">pustule<\/span> evolves rapidly in a deep <span class=\"term\" data-term-id=\"1182\">purulent<\/span> ulcer with <span class=\"term\" data-term-id=\"1190\">violaceous<\/span> undercut edges and possible satellite injury.<\/li>\n<li>Often <span class=\"term\" data-term-id=\"1497\">precipitate<\/span> from a minor injury at the ulceration site.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Hidradenitis-supurativa\"><\/span>Hidradenitis suppurativa<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>It comes with <span class=\"term\" data-term-id=\"511\">pseudocysts<\/span>inflammatory <span class=\"term\" data-term-id=\"367\">nodules<\/span>, sinus drainage and abscesses.<\/li>\n<li>Ulceration may be associated with <span class=\"term\" data-term-id=\"254\">pyogenic<\/span> granuloma-like nodules.<\/li>\n<li>The skin on the labia majora, pubis, thighs, buttocks, and under the armpits and breasts may be affected.<\/li>\n<\/ul>\n<h3><span class=\"ez-toc-section\" id=\"Carcinoma-de-celulas-escamosas\"><\/span>Squamous cell carcinoma<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<ul>\n<li>A magnification, irregular red, pink, or white <span class=\"term\" data-term-id=\"198\">nodule<\/span> or <span class=\"term\" data-term-id=\"235\">license plate<\/span> It has a wart-like and \/ or ulcerated surface.<\/li>\n<li>Squamous cell carcinoma can arise within intraepithelial neoplasia, lichen sclerosus, erosive lichen planus, or normal skin.<\/li>\n<\/ul>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFComo-se-diagnostican-las-ulceras-vulvares\"><\/span>How are vulvar ulcers diagnosed?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>Diagnosing vulvar ulceration involves taking a careful history and performing a physical exam to assess the risk of STIs, guide appropriate investigations, and determine the need for empirical therapy.<\/p>\n<p>It&#039;s important to put attention on:<\/p>\n<ul>\n<li>More than one cause can coexist<\/li>\n<li>There are various presentations of the disease, so the clinical appearance alone can be misleading.<\/li>\n<li>People with immunosuppression can have atypical presentations.<\/li>\n<\/ul>\n<p>Not <span class=\"term\" data-term-id=\"586\">pathogen<\/span> it is identified in up to 25% of the patients; However, the focus of initial research generally focuses on diagnosing STIs. Patients must, at a minimum, have the following investigations:<\/p>\n<ul>\n<li>Genital Viral Swabs <span class=\"term\" data-term-id=\"164\">injury<\/span> for HSV <span class=\"term\" data-term-id=\"941\">Polymerase chain reaction<\/span> (<span class=\"term\" data-term-id=\"942\">PCR<\/span>)<\/li>\n<li>Syphilis blood <span class=\"term\" data-term-id=\"621\">serology<\/span>.<\/li>\n<\/ul>\n<p>Since co-infections are common and many STIs are asymptomatic, patients with recent unprotected sexual contact should also undergo testing for non-ulcer STIs through:<\/p>\n<ul>\n<li>Urine PCR for chlamydia and gonorrhea\n<\/li>\n<li>Bloods for HIV, and <span class=\"term\" data-term-id=\"1801\">hepatitis<\/span> Serology B and C.<\/li>\n<\/ul>\n<p>The geographical location of the STI acquisition, the individual&#039;s and local&#039;s travel and sexual history <span class=\"term\" data-term-id=\"589\">predominance<\/span> Chancroid, LGV, and inguinal granuloma should be considered pretests for these STIs.<\/p>\n<p>In patients with low risk of STIs or in those who have had negative results, depending on the clinical presentation, it is reasonable to consider:<\/p>\n<ul>\n<li>\n<p>Bacterial swabs for gram staining and bacterial and yeast <span class=\"term\" data-term-id=\"837\">culture<\/span>\n<\/li>\n<li>\n<p>Viral swabs for VZV PCR<\/li>\n<li>Blood for:\n<ul>\n<li>\n<p>HSV (HSV 1 and HSV 2), EBV (<span class=\"term\" data-term-id=\"428\">immunoglobulins<\/span> M and G) or a Monospot, CMV and mycoplasma serology test<\/li>\n<li>A complete blood count <span class=\"term\" data-term-id=\"946\">C-reactive protein<\/span>and antinuclear <span class=\"term\" data-term-id=\"425\">antibody<\/span> tests<\/li>\n<li>Test for<em> <span class=\"term\" data-term-id=\"1245\">HLA<\/span>-B51<\/em> if Beh\u00e7et&#039;s disease is a possibility.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>A <span class=\"term\" data-term-id=\"24\">biopsy<\/span> It may be necessary if:<\/p>\n<ul>\n<li>A diagnosis cannot be made by<span class=\"term\" data-term-id=\"612\">invader<\/span> methods<\/li>\n<li>Ulcers do not resolve after standard therapy.<\/li>\n<li>The injuries are suspected of an underlying disorder or malignancy.<\/li>\n<\/ul>\n<div id=\"square-placement-country-holder\" class=\"country-dependent advert\">\n<div class=\"box-placement square-placement\">\n<div class=\"advert__frame\">\n<div id=\"dermnet-dermnet-mobbox\">\n<\/div><\/div><\/div><\/div>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCual-es-el-tratamiento-para-la-ulceracion-vulvar\"><\/span>What is the treatment for vulvar ulceration?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<h3><span class=\"ez-toc-section\" id=\"Medidas-generales\"><\/span>General measures<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Whatever the cause, patients with vulvar ulcers may need education, peace of mind, and <span class=\"term\" data-term-id=\"902\">symptom<\/span> relief.<\/p>\n<p>Affected people can:<\/p>\n<ul>\n<li>Minimize <span class=\"term\" data-term-id=\"1443\">irritants<\/span> (no soaps, showers, pads, tight underwear or clothing)<\/li>\n<li>Consider using <span class=\"term\" data-term-id=\"1126\">spray<\/span> feeding bottles or evacuating in a bathroom to reduce pain when urinating<\/li>\n<li>Try salt baths<\/li>\n<li>Apply cold compresses (eg, a flannel soaked in cold water)<\/li>\n<li>Use soft barrier ointments (eg, Vaseline, zinc oxide)<\/li>\n<li>Apply one <span class=\"term\" data-term-id=\"1330\">current<\/span> <span class=\"term\" data-term-id=\"1206\">anesthetic<\/span> (eg lignocaine <span class=\"term\" data-term-id=\"1123\">gel<\/span>, lignocaine \/ prilocaine <span class=\"term\" data-term-id=\"1121\">cream<\/span>)<\/li>\n<li>Use oral pain relievers (acetaminophen, NSAIDs) as needed.<\/li>\n<\/ul>\n<p>Oral antihistamines can also be beneficial in certain cases.<\/p>\n<p>Note: severe pain and urinary retention may require hospitalization and catheterization.<\/p>\n<h3><span class=\"ez-toc-section\" id=\"Tratamiento-especifico\"><\/span>Specific treatment<span class=\"ez-toc-section-end\"><\/span><\/h3>\n<p>Treatment of infectious causes may include:<\/p>\n<ul>\n<li>Oral acyclovir, famciclovir, or valaciclovir for herpes simplex or zoster\n<\/li>\n<li>Intramuscular penicillin G (benzylpenicillin) for primary syphilis\n<\/li>\n<li>Intramuscular ceftriaxone or oral azithromycin, ciprofloxacin, or erythromycin for chancroid\n<\/li>\n<li>Oral doxycycline for LGV and inguinal granuloma.<\/li>\n<\/ul>\n<p>Note: Empirical treatment is initiated when there has been a known exposure to an STI, genital ulcers are indicative of HSV, there is a high risk of syphilis, or when failed follow-up of treatment is likely.<\/p>\n<p>Treatment of non-infectious causes may include:<\/p>\n<ul>\n<li>\n<p>Topical corticosteroids or intralesional corticosteroids.\n<\/li>\n<li>Oral corticosteroids<\/li>\n<li>\n<p>Antibiotics or antifungal agents in cases of secondary infection.<\/li>\n<li>\n<span class=\"term\" data-term-id=\"680\">Immunomodulator<\/span> agents such as methotrexate, topical or systemic cyclosporine\n<\/li>\n<li>Referral to appropriate specialists (eg, Rheumatologist, <span class=\"term\" data-term-id=\"54\">dermatologist<\/span>, gynecologist, sexual health doctor, infectious disease doctor).<\/li>\n<\/ul>\n<p>Note: Many conditions involving vulvar ulceration require a multidisciplinary approach.<\/p>\n<h2><span class=\"ez-toc-section\" id=\"%C2%BFCual-es-el-resultado-de-la-ulceracion-vulvar\"><\/span>What is the result of vulvar ulceration?<span class=\"ez-toc-section-end\"><\/span><\/h2>\n<p>the <span class=\"term\" data-term-id=\"241\">forecast<\/span> of vulvar ulcers depends on the cause.<\/p>\n<ul>\n<li>Most STIs can be cured quickly with the right treatment.<\/li>\n<li>\n<p>HSV cannot be cured, but recurrences can be controlled with early recognition and <span class=\"term\" data-term-id=\"1512\">antiviral<\/span> <span class=\"term\" data-term-id=\"1737\">prophylaxis<\/span>. The severity and frequency of episodes may decrease over time.<\/li>\n<li>\n<p>Non-sexually acquired genital ulcers usually resolve on their own without scarring in 2 to 6 weeks.<\/li>\n<\/ul>\n<p>Left untreated, vulvar ulcers can have serious health consequences, including:<\/p>\n<ul>\n<li>Increased risk of HIV transmission for sexually active people<\/li>\n<li>Persistent <span class=\"term\" data-term-id=\"1040\">latent<\/span> untreated syphilis infection, resulting in occult transmission to sexual partners and progression to secondary or tertiary syphilis<\/li>\n<li>Risk of transmission of STIs to a fetus in pregnancy or to a <span class=\"term\" data-term-id=\"1193\">newborn<\/span> during birth<\/li>\n<li>Scarring, adhesions or destruction of the vulvar architecture in erosive lichen planus, lichen sclerosus, Beh\u00e7et&#039;s disease, mucous membrane pemphigoid (cicatricial pemphigoid), pemphigus vulgaris, erythema multiforme major, epidermolysis bullosa, and suppurative hydradenitis\n<\/li>\n<li>Increased risk of malignancy in areas affected by severe inflammation, such as erosive lichen planus, lichen sclerosus, and occasionally chronic suppurative hydradenitis\n<\/li>\n<li>On going <span class=\"term\" data-term-id=\"394\">psychosocial<\/span> anguish.<\/li>\n<\/ul>\n<\/section>","protected":false},"excerpt":{"rendered":"<p>Que son vulvares \u00falceras? \u00dalceras vulvares (llagas o erosiones) son roturas en la piel o mucoso membranas de la vulva que exponen el tejido subyacente. Pueden causar picaz\u00f3n o dolor&#8230;.<\/p>","protected":false},"author":8,"featured_media":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","format":"standard","meta":{"footnotes":""},"categories":[204],"tags":[],"class_list":["post-7939","wiki","type-wiki","status-publish","format-standard","category-glosario-definiciones"],"_links":{"self":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/7939","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki"}],"about":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/types\/wiki"}],"author":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/comments?post=7939"}],"version-history":[{"count":0,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/wiki\/7939\/revisions"}],"wp:attachment":[{"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/media?parent=7939"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/categories?post=7939"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/doctorhoogstra.com\/en\/wp-json\/wp\/v2\/tags?post=7939"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}