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Dr. Andrew Rynne

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Have canker sores on outer labia. Tested negative for herpes. What this could be?

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Dr. Aparna Kohli

General & Family Physician

Practicing since :2009

Answered : 983 Questions

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Posted on Tue, 15 Jan 2013 in Vaginal and Uterus Health
Question: I have about 8 canker sores on my outer labia. Had fewer sores but essentially the same thing happen back in march and August of 2011. Have been tested for herpes both times. Currently awaiting results of a third std test. All have been negative. WHT could this be?!?
doctor
Answered by Dr. Aparna Kohli 7 hours later
Hi,
Thanks for writing to us,
There are multiple causes of genital ulcers and you would need to be evaluated for each of them. These include syphilis, chancroid (which is a bacterial infection exclusively transmitted through sexual contact), trauma, thrush ( a Candida infection), eczema, Behcet’s disease, or drug reactions. If the ulcers are painful, we should be considering chancroid which is a sexually transmitted illness. Also, we should be looking to rule out trauma ( which includes trauma from rough clothing or rough sexual intercourse), or a skin issue. If the STD screens come out negative, the next logical step would be to take a biopsy from the edge of the ulcer and look it under the microscope. This should help us have an idea of what is causing the problem.
Also as far as the herpes is concerned, I would like to know which tests have been done to rule out the illness.
Hope that helps
Let me know if you have any additional concerns.
Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Aparna Kohli 9 hours later
I've had a similar breakout one other time and I had a blood test that revealed hsv1. Now the breakout is much worse this time but in the same exact spot. I went in for another blood test and she also swabbed the then unopened blister for a culture. I may even go back for another culture now that the sores are open. What do you think? Both episodes have been preceded by hypersensitivity to cold and touch where the break out occurs. I have also had this same nerve pain extend all the way down to my toes via the back of my thighs wrapping around anteriorly. I thought it was post herpatic nerve pain but I don't always get sores when this pain is at it's Worst

doctor
Answered by Dr. Aparna Kohli 12 hours later
Hi,
Thanks for writing back.
Given your description, it sounds like a recurrent attack of herpes. Recurrent attacks could be milder or worse depending on the status of your immune system. For the pain, it typically precedes the appearance of blisters. We should also be considering the possibility of zoster although that typically doesnt involve the legs and would be possible only if you had chicken pox as a child. Few cases of zoster have been reported however, which have involved the labia and the legs. Post herpatic pain or post herpatic neuralgia is a known entity which typically follows zoster, not HSV-1 infection.
For further testing, let me know the results of the tests that you have already undergone.
Best
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Aparna Kohli 46 minutes later
Thanks so much. Will report to you as soon as I know

XXXXXXX
doctor
Answered by Dr. Aparna Kohli 13 minutes later
Hi XXXXXXX
I look forward to hearing from you again
Best
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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