Q: I have vaginal ulcers on labia minora. They started on and off six to seven months ago but always disappeared within 3-4 days with anti fungal cream. Two months ago I had the first severe ulcer, which became 1 c.m. in diameter and had created a hole in the skin. It had pus but became okay after one month. I had a course of Augmentin then. Almost simultaneously, just near the old ulcer, a new ulcer started and became bigger than the previous one. This also had pus and was extremely painful. Another ulcer appeared near just below the previous ulcer and is again about 1.5 cms in diameter. I now have 2 extremely large, painful ulcers inside of my labia minora. My whole right side of the vagina is swollen and oozing pus. I have been tested negative for herpes and any significant bacterial infection. I am in extreme pain, not able to walk, surviving on pain killers somehow. I am 30 years old and was diagnosed with erythema nodosum about two years ago and was on 6 months course of steroids. My partner does not have any STD and my HIV test during and before pregnancy was negative. I never had any sex partner except my husband.

A:By your clinical description you don't seem to have herpes genitalis. In this condition, there are grouped vesicles and ulcers. A large ulcer can form from the fusion of smaller ones, but then it has a distinct appearance. Normally they are shallow unless secondarily infected. By your description you seem to have a kind of apthous ulcer. Usually they occur in the mouth. These can occur in a condition called Behcets disease. Erythema nodosum can occur in this condition also. Recurrent or genital ulcers may also be associated with some underlying disorder. I suggest you consult a good Dermatologist in your area. Management will depend upon a proper diagnosis.