Multiple discrete ulcers located on the vulva and perianal area in chancroid.
(Courtesy Dr. N.J. Fuimara.)

Severe primary outbreak of herpes simplex.

Recurrent herpes simplex with periclitoral pustule and erosion.

Extensive nonhealing perianal ulcers and erosions resulting from herpes simplex in a patient with lymphoma.

Herpes Simplex

Herpes Simplex

Groups of vesicles and confluent pustules

Swelling of the right labium minor with vesicles and pustules on buttocks in herpes zoster.

Extensive vesicles, erosions, and pustules in S3 to S4 (and hemorrhoid) from the varicella-zoster virus (VZV).

Hidradenitis Suppurativa

Scars, nodules, and cysts in right inguinal area in hidradenitis suppurativa.

Acute punched-out aphthous ulcer.

Aphthous ulcers

Aphthous ulcers

Aphthous ulcers, healing.

Aphthous ulcers in a young teenager, never sexually active.

Crohn Disease

Ulcer with necrotic base on the perihymenal area at the 6 o’clock position in Crohn disease.

“Knife cut” ulcer of perianal area/perineum in Crohn disease.

Deep punched-out vulvar ulcers (all connected with sinuses on the right labium major) in Behçet’s. This 16 year old had had painful ulcers for 3 years with what she thought was a sexually transmitted disease. She finally presented when she could not walk. She had had oral aphthae for years. She had small gastrointestinal ulcers on sigmoidoscopy, synovitis, and a positive pathergy test.

Eroded ulcers of the vulva in lichen planus.

Squamous Cell Carcinoma

Well-circumscribed ulcerated, bleeding, squamous cell carcinoma in a scarred lichen sclerosus. (Courtesy Dr. P. Bryson.)

Ulcerated malignant melanoma of the vulvar trigone and inner labium minor. (Courtesy Dr. A. Covens.)

Syphilitic chancre on labium major.

Chronic edema of the labia in LGV.

“Groove sign” in the right inguinal area from lymphogranuloma venereum (LGV).

Multiple, beefy-red, thick, granulating ulcers in granuloma inguinale.
(Courtesy Dr. J. Keystone.)