Adolescents with Vulvar Ulcers: COVID-19 disease, COVID-19 Vaccines, and the Value of Case Reports

Huppert, Jill S.

doi:10.1016/j.jpag.2022.01.006

Cited by 14 publications

(17 citation statements)

References 21 publications

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“…Moreover, the duration of the ulcer was similar between the two: 19.6 (range, 10-34) days and 16-21 (range, 5-52) days for the vaccine-associated and the Lipschutz ulcers, respectively. 1,2,18,21 Besides the post-ulcer period, the pre-ulcer period was shorter in vaccine-associated ulcers than in Lipschutz ulcers: the time interval from pathogen exposure to ulcer onset was 2.4 ± 1.2 (0-4) days [95% CI: 1.7-3.0, n = 14] and 8.6 ± 6.0 (range, 3-18) days [n = 7] for vaccine-associated ulcer and Lipschutz ulcer (where the pathogen exposure was surrogated by tonsillitis), respectively. 1 The more rapid progression is probably due to no need for the replication of viable pathogens in the vaccine-associated ulcer.…”

Section: Discussionmentioning

confidence: 99%

“…A recent review reported a temporal association between vulvar ulceration and COVID‐19 vaccines 17 . However, we cannot exclude the possibility that the association between the vaccine receipt and the ulceration is coincidental because the vaccine is administered to many people in a short span 18 . Additional evidence is needed to infer the cause‐effect relationship.…”

Section: Introductionmentioning

confidence: 94%

“…27 There were 4 articles that were not the case reports: a review on Behçet's disease that referred to oro-genital ulcers, 28 an original article on a potential COVID drug, 29 and 2 editorials on vulvar ulcers following COVID-19 vaccination. 18,30 day after the second dose of the BNT162b2 (Pfizer) vaccine. On the second day, she developed painful ulcers of the labia minor and visited our hospital.…”

Section: Casementioning

confidence: 99%

“…17 However, we cannot exclude the possibility that the association between the vaccine receipt and the ulceration is coincidental because the vaccine is administered to many people in a short span. 18 Additional evidence is needed to infer the cause-effect relationship. Therefore, to find more evidence of a close association between vaccination and ulceration that supports the causal relationship, we reviewed reported cases.…”

Section: Introductionmentioning

confidence: 99%

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Acute vulvar ulcer as a possible adverse event of gene‐basedCOVID‐19 vaccines: A review of 14 cases

Kanetani

Obuchi

Ishikawa

et al. 2023

J of Obstet and Gynaecol

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Aim: To evaluate whether an acute vulvar ulcer that developed after the COVID-19 vaccine administration is an adverse effect of the vaccine. Methods: This is a descriptive study of two cases that we observed in addition to cases that have been reported in the literature. We searched for case reports in the PubMed. The consistency of clinical manifestations among cases and the association between ulceration and vaccination were assessed. Results: Fourteen female patients were identified, including 12 patients from 8 literatures published in 2021 and 2022 and 2 patients from our cases. Of the 14 patients, 11 had received the BNT162b2 vaccine, 2 had received the ChAdOx1 nCoV-19 vaccine, and one had received the mRNA-1273 vaccine. The patient's ages were 16.9 ± 5.0 (mean ± SD) years. Postvaccination, the disease progressed in the following sequence (time interval from vaccination): fever and other systemic inflammatory reactions (0.9 ± 0.4 days), development of vulvar ulcers (2.4 ± 1.2 days), and resolution of the ulcer (16.9 ± 7.4 days). The ulcers eventually healed in all cases, except one where the prognosis was not noted. For two-dose vaccine recipients, more patients developed the ulcer after the full vaccination (the second or third doses) compared with after the first dose: n = 10 and n = 2, respectively. Conclusion: The acute vulvar ulcer was closely associated with COVID-19 vaccination in terms of temporality and vaccine doses, supporting the notion that a vulvar ulcer is an adverse event of the COVID-19 vaccines.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Section: Casementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Acute vulvar ulcer as a possible adverse event of gene‐basedCOVID‐19 vaccines: A review of 14 cases

Kanetani

Obuchi

Ishikawa

et al. 2023

J of Obstet and Gynaecol

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“…Etiology is not completely understood but there is believed to be a large immunologic component given a high association with a recent viral or bacterial infection. 1 , 2 , 3 , 4 , 5 Most recently, several case reports and case series have been published describing the development of vulvar ulcers during infection with SARS-CoV-2 as well as after COVID-19 vaccination. 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 In this report, we describe a series of eight cases of perimenarchal adolescent females who developed vulvar aphthous ulcers subsequent to COVID-19 vaccination without evidence of prior SARS-CoV-2 infection.…”

Section: Introductionmentioning

confidence: 99%

Vulvar Aphthous Ulcers in Perimenarchal Adolescents after COVID-19 Vaccination: A Multicenter Case Series

Sartor

Lawson

Moncada-Madrazo

et al. 2023

Journal of Pediatric and Adolescent Gynecology

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COVID-19, Coronavirus Vaccines, and Possible Association with Lipschütz Vulvar Ulcer: A Systematic Review

Vismara

Ridolfi

Faré

et al. 2023

Clinic Rev Allerg Immunol

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Lipschütz genital ulcer is a self-limited, non-sexually acquired disorder characterized by the sudden onset of a few ulcers. A primary Epstein-Barr virus infection is currently considered the most recognized cause. Recent reports document cases temporally related with coronavirus disease 2019 (COVID-19) or immunization against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We carried out a review of the literature to investigate the possible association between COVID-19 or the immunization against SARS-CoV-2 and genital ulcer. The pre-registered study (CRD42023376260) was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses methodology. Excerpta Medica, the National Library of Medicine, and Web of Sciences were searched. Inclusion criteria encompassed instances of acute Lipschütz ulcer episodes that were temporally linked to either COVID-19 or a vaccination against SARS-CoV-2. Eighteen articles were retained. They provided information on 33 patients 15 (14–24) years of age (median and interquartile range), who experienced a total of 39 episodes of Lipschütz ulcer temporally associated with COVID-19 (N = 18) or an immunization against SARS-CoV-2 (N = 21). The possible concomitant existence of an acute Epstein-Barr virus infection was excluded in 30 of the 39 episodes. The clinical presentation and the disease duration were similar in episodes temporally associated with COVID-19 and in those associated with an immunization against SARS-CoV-2. In conclusion, COVID-19 and immunization against SARS-CoV-2 add to Epstein-Barr virus as plausible triggers of Lipschütz genital ulcer.

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Adolescents with Vulvar Ulcers: COVID-19 disease, COVID-19 Vaccines, and the Value of Case Reports

Cited by 14 publications

References 21 publications

Acute vulvar ulcer as a possible adverse event of gene‐basedCOVID‐19 vaccines: A review of 14 cases

Acute vulvar ulcer as a possible adverse event of gene‐basedCOVID‐19 vaccines: A review of 14 cases

Vulvar Aphthous Ulcers in Perimenarchal Adolescents after COVID-19 Vaccination: A Multicenter Case Series

COVID-19, Coronavirus Vaccines, and Possible Association with Lipschütz Vulvar Ulcer: A Systematic Review

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