Vulvar ulcerations in girls with myelocytic leukemia

To determine the prevalence of vulvar ulcerations in girls with myelocytic leukemia receiving chemotherapy, we reviewed the records of 108 patients. At the time of diagnosis, 69 patients were prepubertal, and the remaining 39 patients were postpubertal. Genital ulcerations were seen in 11 girls (10%), all of whom were white and postpubertal. None of the prepubertal girls complained of vaginal bleeding or had vulvar or vaginal ulcers. The findings suggest that genital ulcerative lesions occur primarily in postpubertal girls, probably because of the distinctive changes that occur during puberty as a result of estrogen stimulation.