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Genital Lesions in a Teenager



Question:
Sofia Reis*, Paulo Morais**
*Department of Pediatrics and **Department of Dermatology, Tondela-Viseu Hospital Center, Viseu, Portugal

Address for Correspondence: Sofia Reis, Department of Pediatrics, Av. Rei D. Duarte, 3504-509 Viseu, Portugal. E-mail: reis.carlasofia@gmail.com

An 11-year-old female was treated with amoxicillin-clavulanic acid for a dental infection. She started having a burning sensation in the left buttock with progressive worsening, extending to the ipsilateral labium majus, and subsequent appearance of skin lesions in that area. There was no history of chickenpox or sexual intercourse. On examination, she was afebrile, in severe pain and had difficulty in walking and difficulty in pelvic movement. She had grouped herpetiform translucent vesicles developing on an erythematous base, located in the left labium majus, perineum and homolateral buttock, associated with focal eroded, exudative and crusted areas, and local parasthesia (Figure 1). There were no vulvar mucosa involvement or regional lymphadenopathies. Investigations for Varicella-Zoster Virus (VZV)-specific IgM was negative and IgG antibodies were positive, while Herpes Simplex Virus (HSV)-1 and 2 serology results were negative. She had normal hemogram, and levels of IgA, IgG and IgM were within normal range [IgA = 69 mg/dL (N: 40-350 mg/dL), IgG = 1150 mg/dL (N: 650-1600 mg/dL), IgM = 99 mg/dL (N: 50-250 mg/dL)].

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WSPID 2017
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