What are the symptoms of acute vulvar ulcer?

In today's society, the incidence of gynecological diseases among women remains high, among which acute inflammation is the most common. Acute vulvar ulcer is a kind of vulvar inflammation disease. Acute vulvar ulcers may cause harm to the body, and in severe cases may lead to ulceration and infertility. It deserves the attention of all female friends. In daily life, we should improve our understanding of acute vulvar ulcers and master their symptoms.

(1) Nonspecific vulvitis: Ulcers often occur after scratching and may be accompanied by symptoms such as low fever and fatigue. The local pain is severe, the ulcers are superficial, the number is small, and there is obvious inflammation around them.

(2) Herpes virus infection: The onset is acute. After contact with the source of herpes simplex virus infection, there is generally an incubation period of 2 to 7 days, followed by fever, malaise, inguinal lymphadenopathy and herpes. Initially, there are multiple herpes, which rupture to form superficial multiple ulcers with severe pain. The ulcers often involve the labia minora, especially on the inner side. More than 50% to 80% of cases involve the vagina, urethra and cervix. The ulcers vary in size, with a gray-yellow bottom and slightly raised edges. They are highly congested and edematous. The ulcers usually heal naturally within 1 to 2 weeks, but they often recur. Because herpes simplex virus affects the vagina, urethra, etc., patients often have a large amount of leucorrhea. The leucorrhea is initially transparent serous, then turbid and thin pus, and finally yellow purulent leucorrhea due to bacterial infection, accompanied by urinary system symptoms: such as urgency and difficulty urinating.

(3) Behçet's disease: Acute vulvar ulcers are common in Behçet's disease, also known as oculo-oral-genital syndrome. In the past, it was believed that acute vulvar ulcers were a benign ulcer caused by non-contact infection of large rod-shaped bacteria. Now, it is generally believed that acute vulvar ulcers are a development stage of Behçet's disease. They can occur simultaneously with or successively with eye and oral lesions. Ulcers can occur widely in various parts of the vulva, but are more common on the inner and outer sides of the labia minora and the vestibule of the vagina. The onset is acute and relapses are common. Clinically, they are divided into three types, which can exist alone or in combination. The gangrenous type is the most serious.

① Gangrenous type: Most of the patients have systemic symptoms first, such as fever and fatigue, etc. The lesion site is obviously red and swollen, the ulcer edge is irregular, there is a digging phenomenon, the local pain is severe, and there is a large amount of pus on the ulcer surface, or a dirty yellow to gray-black necrotic pseudomembrane. After removal, the base is uneven. The lesion develops rapidly and can cause defects in the labia minora. The appearance is similar to vulvar cancer, but the edges and base are soft and there is no infiltration.

② Chancroid type: more common, generally with mild symptoms and slow course, more ulcers and shallower ulcers, redness and swelling around the ulcers, irregular edges, and may also have digging. It usually heals within a few weeks, but new ulcers often appear nearby during the healing stage of old lesions.

③Milliary type: The ulcers are the size of a needle tip to a grain of rice, are numerous, heal quickly, and the subjective symptoms are mild.

(4) Sexually transmitted diseases such as syphilis, chancroid and lymphogranuloma venereum can all cause acute vulvar ulcers.

① Syphilis: Acute vulvar ulcers of syphilis can appear in the primary and secondary stages of syphilis. Ulcers may occur on the surface of the syphilitic rash. After a latent period of 2 to 4 weeks after infection with syphilis, the initial syphilitic lesion, namely chancre, appears at the site where the spirochete invades. It is characterized by painless, red, round, 1 to 2 cm in diameter, shallow ulcers on the surface, neat edges, raised peripheries, smooth sore surfaces, dark red in color, with serous purulent secretions on the surface. The ulcers are mostly single and located on the labia majora and minora and the frenulum of the labia, and can also be seen on the clitoris, urethral orifice or cervix.

② Chancroid: Ulcers are often multiple, with an average of 4 to 5 primary ulcers in women. The ulcers can then implant themselves, and clusters of small ulcers can form around them. Ulcers generally heal after 1 to 2 months. Initially, small inflammatory papules appear in the affected area, surrounded by red halos, which turn into pustules in 1 to 2 days, and then rupture to form erosions, which then expand to form ulcers. The ulcers vary in size, with a diameter of 1 to 20 mm, rough and sloping edges, clear borders, and surrounding red halos. The base is soft and dark, covered with gray or yellow necrotic purulent secretions. Removal of the dirty purulent secretions reveals a granuloma-like base that is tender and easy to bleed.

③ Lymphogranuloma venereum begins as a single papule and herpes, blisters or pustules, without pain or infiltration, and then breaks down into erosions or shallow ulcers. The ulcers are prone to occur in the vestibule, labia minora, vaginal opening and around the urethra. The lesions are regular in shape, with flat edges and shallow surface. They heal on their own after several days to half a month without leaving scars.