Vulvar aphthous ulcer, also known as acute genital ulceration or Lipschutz ulcers, is an uncommon, non‐sexually acquired condition characterized by sudden onset ulcerations of the vulva in young girls and women. It is thought to represent an immunologic reaction to an infection or other source of inflammation and is commonly preceded by prodromal symptoms including fever, chills, fatigue, and malaise. During the COVID‐19 pandemic, vulvar aphthous ulcer associated with COVID‐19 infection has been reported. Here, we report a case of vulvar aphthous ulcer in response to COVID‐19 vaccination.

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A man in his 30s presented with a 3-year history of a painful, pruritic eruptions that affected his face, trunk, and extremities. He had a history of seizures, asthma, and mediastinal and hilar adenopathy incidentally noted on prior chest imaging results. Physical examination revealed indurated violaceous papules on the nasal alae and medial periorbital skin (Figure), hypopigmented indurated plaques on the bilateral upper extremities and back, and verrucous plaques on the lower extremities and back. Histopathologic examination showed a granulomatous infiltrate comprising small nodular aggregates of epithelioid histiocytes with a mild lymphocytic infiltrate in the dermis. Repeated chest imaging results showed interval improvement in adenopathy, and spirometry results were normal. He was treated with hydroxychloroquine, methotrexate, and topical triamcinolone with resolution of cutaneous lesions.Sarcoidosis is a multisystem granulomatous disorder that affects individuals of all ages, sexes, races, and ethnicities. The etiologic agent remains unknown, but the pathogenesis likely involves a complex interplay of a genetic predisposition, appropriate environmental exposure, and resulting immune response. 1 Sarcoidosis most commonly affects the lungs in 90% of patients, and 20% to

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