What is the most likely diagnosis for a female with multiple ulcerative lesions on her labia and perineum with a Tzanck preparation revealing multinucleated giant cells?

The presence of multiple ulcerative lesions on the labia and perineum, along with a Tzanck preparation revealing multinucleated giant cells, strongly indicates a diagnosis of Herpes Simplex Virus (HSV) infection. Tzanck smears are used to identify herpesvirus infections, and they are particularly helpful in cases where vesicular lesions are present. The observation of multinucleated giant cells is characteristic of infections caused by HSV, as the virus causes cell fusion and leads to the formation of these atypical cells.

In the context of this question, HSV typically presents with painful, ulcerative lesions on the genitalia. The acute onset of these lesions can also be accompanied by systemic symptoms such as fever and lymphadenopathy, further supporting the diagnosis of a primary or recurrent herpes infection.

Considering the other conditions listed, Molluscum contagiosum generally presents as flesh-colored, dome-shaped papules, rather than ulcerative lesions, and does not produce multinucleated giant cells on Tzanck preparation. Human Papillomavirus (HPV) is associated with warts or lesions known as condylomata acuminata and is identified through different diagnostic techniques, without the characteristic findings seen in HSV. Syphilis may present with