Lipschütz ulcer

Lipschütz ulcer
One of the first published cases of Lipschütz ulcer[1]

Lipschütz ulcer, ulcus vulvae acutum or reactive non-sexually related acute genital ulcers (English: acute ulceration of the vulva) is a rare disease characterized by painful genital ulcers, fever, and lymphadenopathy, occurring most commonly, but not exclusively, in adolescents and young women.^[2] Previously, it was described as being more common in virgins.^[3] It is not a sexually transmitted infection, and is often misdiagnosed,^[4][5] sometimes as a symptom of Behçet's disease.^[6]

Lipschütz ulcer is named after Benjamin Lipschütz, who first described it in 1912.^[1][5] The cause is still unknown, although it has been associated with several infectious causes, including paratyphoid fever, cytomegalovirus, Mycoplasma pneumoniae and Epstein–Barr virus infection^{[7][8][9][10]}

Signs and symptoms

The most common presentation is a single large, deep ulcer (although several smaller ulcers may occur) in the internal surface of one or both labia minora.^[11] The labia majora may be affected, as may the vagina and urethra. The ulcer develops very quickly, and is usually preceded by sudden onset of fever and malaise.^[11]

Diagnosis

The diagnosis is mainly clinical and centred in eliminating other more common causes for vulvar ulcers. Nevertheless, it has been proposed that Epstein-Barr detection using polymerase chain reaction for virus genome can help to reach sooner a diagnosis.^[7]

Treatment

Treatment is symptomatic, and usually of little value; in most cases, the ulcer heals spontaneously within four to six weeks, sometimes leaving scars. Topical analgesics and anesthetics, as well as topical application of disinfectants/astringents such as potassium permanganate (in sitz baths), is commonly used.^[11] In severe cases, a combination of systemic glucocorticoids and broad-spectrum antibiotics has been recommended.^{[citation needed]}

Epidemiology

The disorder typically appears among young girls and adolescents but cases in children as young as 17 months have been reported.^[7]

History

The disease was first described in October 1912 by Galician-born Austrian dermatologist and microbiologist Benjamin Lipschütz, who published a series of four cases in girls aged 14 to 17.^[1] He initially ascribed the ulcer to infection with "Bacillus crassus" (Lactobacillus acidophilus).^[1][5]

See also

• Vulvovaginal health

References

External links

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