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