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It’s not always that simplex
  1. Georgina Alice Fremlin1,
  2. Shirin Irani2,
  3. Annette Loffeld1
  1. 1Department of Dermatology, Solihull Hospital, Heart of England NHS Foundation Trust, Birmingham, UK
  2. 2Department of Obstetrics and Gynaecology, Birmingham Heartlands Hospital, Heart of England NHS Foundation Trust, Birmingham, UK
  1. Correspondence to Dr Georgina Alice Fremlin, Dermatology Department, Solihull Hospital, Heart of England NHS Foundation Trust, Birmingham, West Midlands B91 2JL, UK; georginafremlin{at}doctors.org.uk

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A 14-year-old girl presented with acute onset, painful, progressive ulceration of her labia minora. She described back pain and chills prior to onset. She was otherwise fit and well and not sexually active. Examination revealed a large, necrotic, violaceous-edged ulcer on her labia minora with brown crust and two smaller ulcerations (figure 1).

Figure 1

(A) On presentation, a large, necrotic, violaceous-edged ulcer on her right labia minora with brown crust. Two smaller, similar ulcerations on the left labia minora and posterior fourchette. (B) After the …

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