College Blues and Hues

Vulvar ulcerations are an entity that practicing gynecologists frequently encounter in daily practice. A 21-year-old nulliparous college student presented with a 3-day history of itching to the genital area with associated tenderness and sore bumps. She was initially treated for vulvovaginal candidiasis and instructed to return several days later for follow-up. Repeat examination revealed multiple coalescent and necrotic-appearing ulcerations confined to the labia minora, vagina, and posterior fourchette. All of the lesions eventually resolved. This case reminds us to broaden our differential diagnosis when considering causes of genital tract ulcerations in reproductive-aged females.