Paucibacillary tubercular vulval ulcer in a sexually inactive pubertal girl: role of therapeutic trial.
BACKGROUND
Genital ulcers in adolescent girls present a complex diagnostic dilemma. Of all the causes of painful vulval ulcer in a virgin girl, tuberculosis is an extremely rare possibility with no case reported in literature.


METHODS
We are reporting a case of tubercular vulval ulcer in a sexually inactive pubertal girl. She had a close contact with active tuberculosis, positive tuberculin skin test, and chronic granulomatous inflammation on vulval biopsy. Therapeutic trial was offered and on follow up visit after 4 weeks, lesion had completely resolved.


CONCLUSIONS
Unlike previous case reports that describe tubercular vulval ulcers in sexually active or post menopausal women our patient was sexually inactive. In endemic areas tuberculosis should be considered in differential diagnosis of vulval ulcers irrespective of sexual history of the patient.
Department of Obstetrics and Gynecology, Dr. Rajendra Prasad Government Medical College Kangra at Tanda, India. cdsharma2005@yahoo.com
Chanderdeep
C
Sharma
Shashank
S
Shekhar
Vikas
V
Sharma
Manupriya
M
Sharma
Tanya
T
Aggarwal
D000293:Adolescent; D000995:Antitubercular Agents / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D004977:Ethambutol / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007538:Isoniazid / Q000627:therapeutic use; D011718:Pyrazinamide / Q000627:therapeutic use; D012293:Rifampin / Q000627:therapeutic use; D012883:Skin Ulcer / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D014374:Tuberculin Test; D014384:Tuberculosis, Female Genital / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D014845:Vulvar Diseases / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology
D000995:Antitubercular Agents; D011718:Pyrazinamide; D004977:Ethambutol; D007538:Isoniazid; D012293:Rifampin