title: Idiopathic genital ulcers in women infected with human immunodeficiency virus.
abstract: A national survey of investigators caring for human immunodeficiency virus (HIV)-infected women was undertaken to describe the clinical presentation of idiopathic genital ulcer disease. Patients with negative syphilis and herpes simplex testing and/or negative genital ulcer biopsy were included in this study. Study participants (n = 29) were generally severely immunocompromised (median CD4 cell count was 50/mm3, and 68% had an acquired immunodeficiency syndrome [AIDS]-defining opportunistic process). Thirty-seven percent had coexistent oral ulcers and 19% had their genital ulcer progress to fistula formation (four rectovaginal and one vaginal-perineal). There was generally a favorable response to topical, systemic, and intralesional steroid treatment. This study suggests that idiopathic or probable aphthous genital ulcers in women have similar clinical characteristics to aphthous oroesophageal ulcers. Although infrequent, these genital ulcers can cause severe morbidity. Further research is warranted to better define the pathophysiology and optimal management.
authors.affiliation: Johns Hopkins University, Baltimore Maryland, USA.
authors.forename: J
authors.initials: J
authors.lastname: Anderson
authors.forename: R A
authors.initials: RA
authors.lastname: Clark
authors.forename: D H
authors.initials: DH
authors.lastname: Watts
authors.forename: M
authors.initials: M
authors.lastname: Till
authors.forename: C
authors.initials: C
authors.lastname: Arrastia
authors.forename: P
authors.initials: P
authors.lastname: Schuman
authors.forename: S E
authors.initials: SE
authors.lastname: Cohn
authors.forename: M
authors.initials: M
authors.lastname: Young
authors.forename: L
authors.initials: L
authors.lastname: Bessen
authors.forename: R
authors.initials: R
authors.lastname: Greenblatt
authors.forename: M
authors.initials: M
authors.lastname: Vogler
authors.forename: S
authors.initials: S
authors.lastname: Swindells
authors.forename: P
authors.initials: P
authors.lastname: Boyer
mesh_terms: D000328:Adult; D005260:Female; D015658:HIV Infections / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D006306:Health Surveys; D006801:Humans; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D019226:Oral Ulcer / Q000150:complications; D012189:Retrospective Studies; D014456:Ulcer / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D014481:United States; D014623:Vaginal Diseases / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D014845:Vulvar Diseases / Q000150:complications* / Q000473:pathology / Q000503:physiopathology