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.[1] Previously, it was described as being more common in virgins.[2] It is not a sexually transmitted disease, and is often misdiagnosed,[3][4] sometimes as a symptom of Behçet's disease.[5]

Lipschütz ulcer is named after Benjamin Lipschütz, who first described it in 1912.[6][4] 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.[6] He initially ascribed the ulcer to infection with "Bacillus crassus" (Lactobacillus acidophilus).[6][4]

See also[edit | edit source]

References[edit | edit source]

  1. 4.0 4.1 4.2 Lipschütz' ulcer at Who Named It? Retrieved on 2009-12-04.
  2. 6.0 6.1 6.2
  3. 7.0 7.1 7.2
  4. 11.0 11.1 11.2

External links[edit | edit source]

Classification

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Contributors: Prab R. Tumpati, MD