Differential diagnosis of ulcerative lesions on the vulva

	More common^*	Less common	Rare
Infectious	HSV in the immunosuppressed patient Primary syphilis	N/A	Cytomegalovirus HIV Granuloma inguinale Lymphogranuloma venereum Chancroid Very rare infections Tuberculosis Amebiasis Schistosomiasis Leishmaniasis Mpox
Noninfectious	Acute vulvar aphthous ulcers Trauma Accidental Iatrogenic	Malignancy Squamous cell carcinoma Melanoma Crohn disease Hidradenitis suppurativa	Other malignancies Basal cell carcinoma Adenocarcinoma Hodgkin and non-Hodgkin lymphoma Pyoderma gangrenosum Langerhans cell histiocytosis Complex vulvar aphthous ulcers Patient-induced trauma

The prevalence categories refer to vulvar manifestations of the listed diseases. The relative frequency of each may vary based on the patient population, geography, and type of clinical practice (eg, gynecology, dermatology, or internal medicine). There are no data on the prevalence of the causes of vulvar ulcers. The prevalence will vary widely in various parts of the world. This is only an estimate for North America.

HIV: human immunodeficiency virus; HSV: herpes simplex virus.

* Vulvar ulcers, in general, are not common. This table represents estimated frequency.

Graphic 96017 Version 6.0

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Differential diagnosis of ulcerative lesions on the vulva

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