Rivero ADM, Ramos GLI, Chávez CKL, Briones A

Language: Spanish
References: 6
Page: 230-233
PDF size: 336.05 Kb.

ABSTRACT

Background. Pediatricians consider vulvar ulcer as an uncommon pathology. However, clinicians specialized in the care of young girls and teenagers with vulvar pathology actually consider vulvar ulcer not to be an infrequent primary complaint.
Case report. We report the case of a 15-year-old girl who presented fever and sore throat for which she was treated with trimethoprim-sulfamethoxazole. Two days after taking the drug she presented hyperpigmented patches with a bullous center that developed into a vulvar ulcer of ~4 cm in diameter. First considered infectious in origin, she received treatment with topical fluconazole and afterwards with amoxicillin clavulanate without any improvement. She was then assessed by a dermatologist, and the diagnosis of fixed drug eruption was established on the basis of the initial morphology of the lesion. She was treated with betamethasone and loratadine as well as topical 1% hydrocortisone. The lesions evolved to complete resolution.
Conclusions. In pediatric practice, it is important for the pediatrician to consider not only infectious and venereal causes in teenage girls with vulvar ulcer, but also allergic drug reactions.

REFERENCES

1. Huppert JS. Lipschutz ulcers: evaluation and management of acute genital ulcers in women. Dermatol Ther 2010;23:533-540.

2. Bandow G. Diagnosis and management of vulvar ulcers. Dermatol Clin 2010;28:753-763.

3. Chen TM, Langston A. Differential diagnosis of vulvar lesions. Disponible en: http://www.uptodate.com/contents/differential-diagnosis-of-vulvar-lesions.

4. Schnyder B. Approach to the patient with drug allergy. Med Clin North Am 2010;94:665-679.

5. Shin HT, Chang MW. Drug eruptions in children. Curr Probl Dermatol 2002;14:153-182.

6. Ozkaya-Bayazit E. Specific site involvement in fixed drug eruption. J Am Acad Dermatol 2003;49:1003-1007.