Lipschütz ulcer

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Lipschütz ulcer
Classification and external resources
Lipschutz ulcer original image.jpg
One of the first published cases of Lipschütz ulcer[1]
ICD-9 616.50

Lipschütz ulcer or ulcus vulvae acutum (English: acute ulceration of the vulva) is a rare disease characterized by painful genital ulcers, fever, and lymphadenopathy, occurring most commonly in adolescents and young women (particularly 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.[1][4] The etiology is still unknown, although it has been associated with several infectious causes, including paratyphoid fever, cytomegalovirus and Epstein-Barr virus infection[6][7][8]

Signs and symptoms[edit]

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.[9] 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.[9]

Diagnosis[edit]

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.[6]

Treatment[edit]

Treatment is symptomatic, and usually of little value; in most cases, the ulcer heals spontaneously within four to six weeks, leaving scars. Topical analgesics and anesthetics, as well as topical application of disinfectants/astringents such as potassium permanganate (in sitz baths), is commonly used.[9] In severe cases, a combination of systemic glucocorticoids and broad-spectrum antibiotics has been recommended.

Epidemiology[edit]

The disorder typically appears among young girls and adolescents but cases in children as young as 17 months have been reported.[6]

History[edit]

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][4]

See also[edit]

References[edit]

  1. ^ a b c d Lipschütz B (October 1912). "Über eine eigenartige Geschwürsform des weiblichen Genitales (Ulcus vulvae acutum)". Arch Dermatol Res (in German) 114 (1): 363–96. doi:10.1007/BF01973166. 
  2. ^ Török L, Domján K, Faragó E (2000). "Ulcus vulvae acutum". Acta Dermatovenereologica Alpina, Pannonia et Adriatica 9 (1). ISSN 1581-2979. 
  3. ^ Kluger N, Garcia C, Guillot B (October 2009). "[Lipschütz acute genital ulcer]". J Gynecol Obstet Biol Reprod (Paris) (in French) 38 (6): 528–30. doi:10.1016/j.jgyn.2009.08.005. PMID 19744804. 
  4. ^ a b c Lipschütz' ulcer at Who Named It? Retrieved on 2009-12-04.
  5. ^ Braun-Falco O, Plewig G, Wolff HH, Burgdorf WHC, Landthaler M, ed. (2005). "Erkrankungen des weiblichen Genitales". Dermatologie und Venereologie (in German). Berlin: Springer. p. 1030. ISBN 978-3-540-40525-2. 
  6. ^ a b c Burguete Archel E, Ruiz Goikoetxea M, Recari Elizalde E, Beristain Rementería X, Gómez Gómez L, Iceta Lizarraga A (May 2013). "Lipschütz ulcer in a 17-month-old girl: a rare manifestation of Epstein-Barr primoinfection". Eur. J. Pediatr. doi:10.1007/s00431-013-2013-8. PMID 23636284. 
  7. ^ Pelletier F, Aubin F, Puzenat E, et al. (2003). "Lipschütz genital ulceration: a rare manifestation of paratyphoid fever". Eur J Dermatol 13 (3): 297–8. PMID 12804994. 
  8. ^ Martín JM, Godoy R, Calduch L, Villalon G, Jordá E (2008). "Lipschütz acute vulval ulcers associated with primary cytomegalovirus infection". Pediatr Dermatol 25 (1): 113–5. doi:10.1111/j.1525-1470.2007.00597.x. PMID 18304169. 
  9. ^ a b c Heller DS, Wallach RC (2007). Vulvar disease: a clinicopathological approach. Informa Healthcare. pp. 51–2. ISBN 0-8493-3793-3.