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]

## Contents

* 1 Signs and symptoms
* 2 Diagnosis
* 3 Treatment
* 4 Epidemiology
* 5 History
* 6 See also
* 7 References
* 8 External links

## 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

1. ↑ 1.0 1.1 1.2 1.3 Lipschütz B (October 1912). "Über eine eigenartige Geschwürsform des weiblichen Genitales (Ulcus vulvae acutum)" (in de). Arch Dermatol Res 114 (1): 363–96. doi:10.1007/BF01973166. https://scholar.archive.org/work/b6v6wnb2fzearlwbr4xq3gimle/access/ia_file/crossref-pre-1923-scholarly-works/10.1007%2Fbf01963479.zip/10.1007%2Fbf01973166.pdf.
2. ↑ Vieira-Baptista, Pedro; Lima-Silva, Joana; Beires, Jorge; Martinez-de-Oliveira, José (2016-03-01). "Lipschütz ulcers: should we rethink this? An analysis of 33 cases". European Journal of Obstetrics, Gynecology, and Reproductive Biology 198: 149–152. doi:10.1016/j.ejogrb.2015.07.016. ISSN 1872-7654. PMID 26297242.
3. ↑ "Ulcus vulvae acutum". Acta Dermatovenereologica Alpina, Pannonia et Adriatica 9 (1). 2000. ISSN 1581-2979. http://ibmi.mf.uni-lj.si/acta-apa/acta-apa-00-1/torok.html.
4. ↑ "[Lipschütz acute genital ulcer]" (in fr). J Gynecol Obstet Biol Reprod (Paris) 38 (6): 528–30. October 2009. doi:10.1016/j.jgyn.2009.08.005. PMID 19744804.
5. ↑ 5.0 5.1 5.2 Lipschütz' ulcer at Who Named It? Retrieved on 2009-12-04.
6. ↑ "Erkrankungen des weiblichen Genitales" (in de). Dermatologie und Venereologie. Berlin: Springer. 2005. pp. 1030. ISBN 978-3-540-40525-2.
7. ↑ 7.0 7.1 7.2 "Lipschütz ulcer in a 17-month-old girl: a rare manifestation of Epstein-Barr primoinfection". Eur. J. Pediatr. 172 (8): 1121–3. May 2013. doi:10.1007/s00431-013-2013-8. PMID 23636284.
8. ↑ "Lipschütz genital ulceration: a rare manifestation of paratyphoid fever". Eur J Dermatol 13 (3): 297–8. 2003. PMID 12804994.
9. ↑ "Lipschütz acute vulval ulcers associated with primary cytomegalovirus infection". Pediatr Dermatol 25 (1): 113–5. 2008. doi:10.1111/j.1525-1470.2007.00597.x. PMID 18304169.
10. ↑ Vieira-Baptista, Pedro; Machado, Luísa; Costa, Ana Rosa; Beires, Jorge; Martinez-de-Oliveira, José (2013-07-01). "Mycoplasma pneumoniae: a rare cause of vulvar ulcers or an undiagnosed one?". Journal of Lower Genital Tract Disease 17 (3): 330–334. doi:10.1097/LGT.0b013e3182710896. ISSN 1526-0976. PMID 23486069.
11. ↑ 11.0 11.1 11.2 Vulvar disease: a clinicopathological approach. Informa Healthcare. 2007. pp. 51–2. ISBN 978-0-8493-3793-2. https://books.google.com/books?id=-u8ki9L4HL0C&pg=PT65.

## External links

Classification|

* ICD-9-CM: 616.50

|

* v
* t
* e

Female diseases of the pelvis and genitals (N70–N99, 614–629)

Internal|

| Adnexa|

| Ovary|

* Endometriosis of ovary
* Female infertility
* Anovulation
* Poor ovarian reserve
* Mittelschmerz
* Oophoritis
* Ovarian apoplexy
* Ovarian cyst
* Corpus luteum cyst
* Follicular cyst of ovary
* Theca lutein cyst
* Ovarian hyperstimulation syndrome
* Ovarian torsion

|

Fallopian tube|

* Female infertility
* Fallopian tube obstruction
* Hematosalpinx
* Hydrosalpinx
* Salpingitis

Uterus|

| Endometrium|

* Asherman's syndrome
* Dysfunctional uterine bleeding
* Endometrial hyperplasia
* Endometrial polyp
* Endometriosis
* Endometritis

menstruation|

* flow
* Amenorrhoea
* Hypomenorrhea
* Oligomenorrhea
* pain
* Dysmenorrhea
* PMS
* timing
* Menometrorrhagia
* Menorrhagia
* Metrorrhagia

* Female infertility
* Recurrent miscarriage

Myometrium|

* Adenomyosis

Parametrium|

* Parametritis

Cervix|

* Cervical dysplasia
* Cervical incompetence
* Cervical polyp
* Cervicitis
* Female infertility
* Cervical stenosis
* Nabothian cyst

General|

* Hematometra / Pyometra
* Retroverted uterus

Vagina|

* Hematocolpos / Hydrocolpos
* Leukorrhea / Vaginal discharge
* Vaginitis
* Atrophic vaginitis
* Bacterial vaginosis
* Candidal vulvovaginitis
* Hydrocolpos

Sexual dysfunction|

* Dyspareunia
* Hypoactive sexual desire disorder
* Sexual arousal disorder
* Vaginismus

* Urogenital fistulas
* Ureterovaginal
* Vesicovaginal
* Obstetric fistula
* Rectovaginal fistula
* Prolapse
* Cystocele
* Enterocele
* Rectocele
* Sigmoidocele
* Urethrocele

* Vaginal bleeding
* Postcoital bleeding

Other / general|

* Pelvic congestion syndrome
* Pelvic inflammatory disease

External|

| Vulva|

* Bartholin's cyst
* Kraurosis vulvae
* Vestibular papillomatosis
* Vulvitis
* Vulvodynia

|

Clitoral hood or clitoris|

* Persistent genital arousal disorder

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