The Vulval ulcers CPG has been updated and reviewed by the CPG Committee and endorsed by the Paediatric Improvement Collaborative (December 2022). The CPG now includes a detailed table with the clinical features for differential diagnoses of vulval ulcers. 

 CPG key points 

1. Most vulval ulcers in children are aphthous or secondary to a systemic infection, rather than due to sexually transmitted infections 
2. Diagnosis on clinical appearance alone is difficult and investigations are often required