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Differential Diagnosis for Internal Labia Ulceration

Single Most Likely Diagnosis

  • Herpes Simplex Virus (HSV) infection: This is a common sexually transmitted infection (STI) that can cause painful ulcers on the genitals, including the internal labia. The presence of a new sexual partner increases the risk of acquiring HSV.

Other Likely Diagnoses

  • Syphilis: Another STI that can cause genital ulcers, often painless, which fits the description of no burning sensation.
  • Trauma: Physical trauma during sexual activity, especially with a new partner, could lead to ulceration of the internal labia.
  • Behçet's disease: A rare condition that can cause genital ulcers, but it's less likely in this scenario without other systemic symptoms.

Do Not Miss Diagnoses

  • Cancer: Although extremely rare in an 18-year-old, genital cancers like vulvar cancer can present with ulcers. Early detection is crucial.
  • Lymphogranuloma Venereum (LGV): An STI caused by certain strains of Chlamydia trachomatis, which can lead to genital ulcers and is important to diagnose due to its potential for serious complications.
  • HIV: While not directly causing ulcers, HIV infection can increase susceptibility to other STIs that cause ulcers, and its diagnosis has significant implications for patient care.

Rare Diagnoses

  • Apthous ulcers: More commonly found in the mouth, but can rarely occur on the genitals.
  • Fixed drug eruption: A condition where certain medications cause skin lesions, including ulcers, in response to drug exposure.
  • Autoimmune disorders: Conditions like pemphigus or pemphigoid can cause blistering and ulcers on the skin and mucous membranes, including the genitals.

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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