Vulva lesion not heal

An year-old woman presented with an ulcerated lesion on the vulva. It was very itchy, but not painful, and had been present for over one year with no significant change to the lesion or surrounding skin. There was no discharge from the lesion, and the patient did not report fever. She had not been sexually active for more than 15 years before the lesion appeared, and had only one partner before that. She had no relevant medical history. Based on the patient's history and physical examination, which one of the following is the most likely diagnosis?

Non-sexually acquired genital ulceration

Ulcers Vulva: Symptoms, Causes, Diagnosis, Treatment, and More

Female genital sores are bumps and lesions in or around the vagina. Some sores may be itchy, painful, tender, or produce a discharge. And, some may not cause any symptoms. Bumps or sores on the genitals sometimes happen for no reason and resolve on their own. Some may be due to certain skin disorders, but they may also be symptoms of a sexually transmitted infection STI. STIs affect all populations and can make a huge impact on public health.

Noninvasive vulvar lesions: An illustrated guide to diagnosis and treatment

DermNet provides Google Translate, a free machine translation service. Note that this may not provide an exact translation in all languages. Non-sexually acquired genital ulceration or NSGU refers to painful ulcers in the genital area.
A year-old female accountant is seen by you for painful lesions in the vulva. Her past medical history is notable only for the use of the hormonal contraceptive patch. She has been married for one year and denies a past history of herpes.
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