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Research Letter
Acquired lymphangioma circumscriptum of the vulva secondary to severe herpes simplex infection
  1. Jenny Anne Callander1,
  2. Branwen Mair Davies2,
  3. Glenda Hill1
  1. 1Department of Dermatology, Wrexham Maelor Hospital, Wrexham, UK
  2. 2Department of Genito-Urinary Medicine, Cardiff Royal Infirmary, Cardiff, UK
  1. Correspondence to Dr Jenny Anne Callander, Dermatology, Wrexham, UK; jenny.callander{at}wales.nhs.uk

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A 43-year-old woman presented to genito-urinary medicine with skin-coloured, papillomatous papules on the mons pubis and superior labia majora (figure 1). Routine sexually transmitted infection screening was normal. Given the papillomatous appearance, a diagnosis of genital warts was made but treatment with cryotherapy and immiquimod cream was unsuccessful.

Figure 1

Skin-coloured papules on the superior labia majora. The papules gradually enlarged and were intermittently complicated by lymphorrhoea.

Further history revealed that subtle vulval papular changes first appeared 6 years previously, following a severe primary genital herpes simplex virus (HSV) type 1 infection, confirmed by PCR, which had caused extreme pain and marked swelling. Treatment with oral acyclovir was delayed by 7 days as the patient was …

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