Lipschütz ulcer
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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 disease, 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[edit | edit source]
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[edit | edit source]
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[edit | edit source]
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.
Epidemiology[edit | edit source]
The disorder typically appears among young girls and adolescents but cases in children as young as 17 months have been reported.[7]
History[edit | edit source]
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[edit | edit source]
References[edit | edit source]
- ↑ 1.0 1.1 1.2 1.3 Lipschütz B, Über eine eigenartige Geschwürsform des weiblichen Genitales (Ulcus vulvae acutum), Arch Dermatol Res, Vol. 114(Issue: 1), pp. 363–96, DOI: 10.1007/BF01973166,
- ↑ Vieira-Baptista, Pedro, Lipschütz ulcers: should we rethink this? An analysis of 33 cases, European Journal of Obstetrics, Gynecology, and Reproductive Biology, Vol. 198 pp. 149–152, DOI: 10.1016/j.ejogrb.2015.07.016, PMID: 26297242,
- ↑ , Ulcus vulvae acutum, Acta Dermatovenereologica Alpina, Pannonia et Adriatica, 2000, Vol. 9(Issue: 1), Full text,
- ↑ , [Lipschütz acute genital ulcer], J Gynecol Obstet Biol Reprod (Paris), Vol. 38(Issue: 6), pp. 528–30, DOI: 10.1016/j.jgyn.2009.08.005, PMID: 19744804,
- ↑ 5.0 5.1 5.2 Lipschütz' ulcer at Who Named It? Retrieved on 2009-12-04.
- ↑ , Dermatologie und Venereologie, Berlin:Springer, 2005, ISBN 978-3-540-40525-2, Pages: 1030,
- ↑ 7.0 7.1 7.2 , Lipschütz ulcer in a 17-month-old girl: a rare manifestation of Epstein-Barr primoinfection, Eur. J. Pediatr., Vol. 172(Issue: 8), pp. 1121–3, DOI: 10.1007/s00431-013-2013-8, PMID: 23636284,
- ↑ , Lipschütz genital ulceration: a rare manifestation of paratyphoid fever, Eur J Dermatol, 2003, Vol. 13(Issue: 3), pp. 297–8, PMID: 12804994,
- ↑ , Lipschütz acute vulval ulcers associated with primary cytomegalovirus infection, Pediatr Dermatol, 2008, Vol. 25(Issue: 1), pp. 113–5, DOI: 10.1111/j.1525-1470.2007.00597.x, PMID: 18304169,
- ↑ Vieira-Baptista, Pedro, Mycoplasma pneumoniae: a rare cause of vulvar ulcers or an undiagnosed one?, Journal of Lower Genital Tract Disease, Vol. 17(Issue: 3), pp. 330–334, DOI: 10.1097/LGT.0b013e3182710896, PMID: 23486069,
- ↑ 11.0 11.1 11.2 , Vulvar disease: a clinicopathological approach. online version, Informa Healthcare, 2007, ISBN 978-0-8493-3793-2, Pages: 51–2,
External links[edit | edit source]
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