Other chronic dermatologic diseases may affect the vulva. The autoimmune blistering diseases, pemphigoid and pemphigus vulgaris, are rare but can involve the vulvar skin in affected women. Behcet's disease involves the triad of genital and oral ulcers as well as ophthalmologic inflammation and may produce very painful chronic ulcers of the vulva. Crohn's disease may also cause vulvar ulcers and fissures that may precede the intestinal manifestations and therefore make diagnosis challenging (11).

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