An 18-year-old woman presents with a fever and headache. She also complains of vaginal itching and dysuria. When asked, she says that she recently became sexually active. Physical examination reveals tender inguinal lymphadenopathy and red, pustular, painful vesicles on her labia majora. What is the most likely diagnosis?

Typical vesicles or pustules or a cluster of painful ulcers preceded by vesiculopustular lesions suggests genital herpes. The pathognomonic findings for herpes infections are painful vesicles. Both HSV-1 and HSV-2 can cause genital herpes, but more than 80% of genital lesions are due to HSV-2. HSV-2 is transmitted by direct contact of the virus with mucosal surfaces or open skin surfaces. Approximately 80% of infected patients are asymptomatic. C/F: The primary infection presents with constitutional symptoms such as fever, headache, malaise, and myalgia. Later, genital vesicles may appear that can rupture and leave behind painful ulcers. Other genital symptoms include itching and tender inguinal lymphadenopathy.