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Reactive non-sexually related acute genital ulcers associated with COVID-19
  1. Jill M Krapf1,2,
  2. Rachel K Casey3 and
  3. Andrew T Goldstein1,2
  1. 1Gynecology, Center for Vulvovaginal Disorders, Washington, DC, USA
  2. 2Obstetrics and Gynecology, The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
  3. 3Pediatric Specialists of Virginia, Inova Fairfax Medical Campus, Department of Obstetrics and Gynecology, Fairfax, Virginia, USA
  1. Correspondence to Dr Jill M Krapf; jillkrapf{at}


Acute genital ulcers (AGU), known as Lipschütz ulcers, are painful vulvar ulcers typically affecting non-sexually active girls and women. AGU have been associated with viral infections, namely, Epstein-Barr virus (EBV). Here, we describe a case of AGU in the setting of SARS-CoV-2 in a non-sexually active adolescent girl hospitalised for pain control and urinary retention, who failed a course of oral corticosteroids and then improved with colchicine. Testing for herpes simplex virus, EBV and Behcet’s syndrome were all negative. Testing for SARS-CoV-2 was positive. COVID-19 increases cytokines such as tumour necrosis factor alpha, which has been shown to affect endothelial cell adhesion and neutrophil chemotaxis, leading to aphthosis.

  • genital ulcers
  • vulvovaginal disorders
  • infectious diseases
  • dermatology

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  • Contributors JMK was involved in conception and design, analysis and interpretation of data, and drafting the article. RKC was involved in acquisition of data, analysis and interpretation of data, and revising the manuscript critically for important intellectual content. ATG was involved in conception and design, acquisition of data, analysis and interpretation of data, and revising the manuscript critically for important intellectual content. All authors approved the final version published. All authors agree to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.