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Acute genital ulcers (AGUs) occur infrequently in nonsexually active girls. AGUs are extremely painful and can lead to dysuria; questions of sexually transmitted infection or abuse may arise. The differential diagnosis is broad and includes infectious agents (herpes simplex virus [HSV] is the most common cause in sexually active females), autoimmune disorders (Behçet disease), trauma, and aphthosis. To offer an approach to the diagnosis, evaluation, and treatment of AGU, these authors retrospectively reviewed charts of nonsexually active females (age, <18 years) treated for AGU at a tertiary care center over a 10-year period.
Exclusion criteria were previous sexual contact/abuse, history of other inflammatory conditions, and negative genital…