Vulvar infections: beyond sexually transmitted infections

Abstract

The vulva is an under-studied area of the female genitourinary tract which is prone to maceration, overgrowth of organisms, and atypical presentations of common dermatologic conditions. In current practice, dermatologists must recognize and manage vulvar infections and infestations beyond the more commonly recognized sexually transmitted infections. Herein, this article reviews the literature on a selection of under-recognized viral, bacterial, fungal, and parasitic vulvar infections and infestations.

Acute vulvar ulcers and the COVID-19 booster vaccine

“…Reactive nonsexually related acute genital ulcers (RNSRAGU) or acute vulvar ulcers (formerly known as Lipschutz ulcers) present as painful ulcers of the lower vagina or vulva and are often associated with a viral prodrome. 1 These ulcers are known to form in response to many infectious triggers, but most recently, reports have been made of RNSRAGU from both COVID-19 infection and vaccination. [1][2][3][4][5] There have been many dermatological reactions to both COVID infection and vaccine in the literature thus far, including acro-ischemia, pityriasis rosea, chilblain-like lesions, vesicular eruptions, and diffuse erythematous rash.…”

“…1 These ulcers are known to form in response to many infectious triggers, but most recently, reports have been made of RNSRAGU from both COVID-19 infection and vaccination. [1][2][3][4][5] There have been many dermatological reactions to both COVID infection and vaccine in the literature thus far, including acro-ischemia, pityriasis rosea, chilblain-like lesions, vesicular eruptions, and diffuse erythematous rash. 1,2,6 Mucosal ulcerations are a known side effect of vaccines historically, but a growing number of cases to the COVID-19 vaccine have been reported.…”

Epidemiology and clinicopathology in genital dermatoses: a retrospective study of 3052 skin biopsy cases

“…Dear Editor, Skin eruptions are the most common toxicity in targeted therapy with the BRAF-inhibitor vemurafenib and MEK-inhibitor cobimetinib (72.5%). 1 In nearly every fifth patient treated with vemurafenib (16.5%), a severe grade ≥3 rash develops. 1 An 80-year-old female with BRAF-V600K mutated melanoma with hepatic and lymphatic metastases developed 10 days after initiation first-line treatment with vemurafenib and cobimetinib a rapidly progressing erythematous-violaceous maculopapular eruption with an erythema multiforme-like aspect (Fig.…”

“…1 In nearly every fifth patient treated with vemurafenib (16.5%), a severe grade ≥3 rash develops. 1 An 80-year-old female with BRAF-V600K mutated melanoma with hepatic and lymphatic metastases developed 10 days after initiation first-line treatment with vemurafenib and cobimetinib a rapidly progressing erythematous-violaceous maculopapular eruption with an erythema multiforme-like aspect (Fig. 1a), fever, facial swelling and fatigue.…”

“…The majority of drug reactions within combined treatment with vemurafenib and cobimetinib are attributed to vemurafenib. 1 In a recent literature review of BRAF-/MEK-inhibitorinduced severe cutaneous adverse reaction (SCAR; n = 31, thereof 23 DRESS), vemurafenib was the culprit drug in all but one case, which was induced by dabrafenib. 2 The US Food and Drug Administration database of Adverse Event Reporting System has documented 125 cases of vemurafenib-associated DRESS between 2011 and 2018.…”