CASE REPORT   

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2020 January-February;179(1-2):85-9

DOI: 10.23736/S0393-3660.19.04031-2

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Genital ulcer related to undifferentiated connective tissue disease: the importance of a correct differential diagnosis in adolescence

Claudio COSSO ¹ ✉, Agnese PALMERI ², Paolo SALA ²

¹ Clinic of Rheumatology, San Martino Policlinc, University of Genoa, Genoa, Italy; ² Clinic of Gynecology, San Martino Policlinc, University of Genoa, Genoa, Italy

There are several cases of mucosal involvement in ANA+ disease. However, in literature, there is no evidence of vaginal involvement. A 25-years-old woman came to us for hard worsening of vaginal lesion in previous Behcet’s diagnosis. The patient showed a vaginal lesion, alopecia, asthenia, diffuse musculoskeletal tenderness and Raynaud’s syndrome. Our analysis showed ANA high positivity (over 1:640) with speckled pattern, no presence of HLA-B51 and no elevation of inflammatory proteins, with polyclonal elevation of gammaglobulins. So we diagnosed undifferentiated connective tissue disease (UCTD) and introduced hydroxychloroquine, we reduced the modified-release prednisone and we suspended colchicine. Patient showed progressive healing of the lesions. In patients with genital aphthosis not responsive to first level therapy and systemic symptoms can be really important to screen ANA to make a prompt and correct differential diagnosis and a specific therapy, preventing evolution in defined connective tissue disease. Expecially in an adolescent girl, this diagnosis is really important in prevision of a possible future pregnancy or the request for contraceptive therapy.

KEY WORDS: Stomatitis, aphthous; Autoimmune diseases; Ulcer; Adolescent