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Vulval ulceration in Crohn's typical herpes case and a Behcets case for comparison

Vulval ulceration in Crohn's typical herpes case and a Behcets case for comparison. A 28 year old woman with two week history of vulval ulceration Past history of Crohn`s Disease , currently off treatment but with some subtle GI symptoms for the last few days.

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Vulval ulceration in Crohn's typical herpes case and a Behcets case for comparison

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  1. Vulvalulceration in Crohn's typical herpes case and a Behcets case for comparison • A 28 year old woman with two week history of vulvalulceration • Past history of Crohn`s Disease, currently off treatment but with some subtle GI symptoms for the last few days. • On examination ulceration was shallow, white and sloughy. HSV PCR was negative and serology showed only HSV type 1 antibodies (probably oral exposure/ cold sores). • Autoimmune conditions (including inflammatory bowel disease) can be a cause of genital ulceration. Refer on to GUM/Dermatology if ulcers not typical of Herpes in appearance or HSV PCR negative. • In this case there was little option but to treat with Aciclovir initially, also given 1% hydrocortisone as I was almost sure it was autoimmune.  I explained to the patient that herpes was unlikely but best treat anyway – just in case.  Important to ensure review when negative results were back and suggest steroid cream if any future recurrences. • The first 2 slides are the Crohn’s patient, 3rd slide typical herpes, 4th slide, typical Behcets with deep large ulceration.

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