Lipschütz Ulcer: An Unusual Diagnosis that Should Not be Neglected

Pereira, Daniela Alexandra Gonçalves; Teixeira, Eliana; Lopes, Ana Cláudia Martins; Sarmento, Ricardo; Calado, Ana

doi:10.1055/s-0041-1729147

Cited by 8 publications

(11 citation statements)

References 11 publications

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“…The etiological distribution is similar to that reported in related studies. In this study, peptic ulcer is still the main cause of bleeding, accounting for 81%, especially duodenal ulcers, which is consistent with the incidence reported in the past [23][24][25][26]. The difference between the two groups was statistically significant, which was consistent with literature reports [27].…”

Section: Discussionsupporting

confidence: 92%

A Cohort Study to Compare Effects between Ulcer- and Nonulcer-Related Nonvariceal Upper Gastrointestinal Bleeding

Nian

Wang

et al. 2022

Applied Bionics and Biomechanics

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Objective. The aim of this study was to better understand the characteristics and etiology of acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) in recent years in this region and to provide evidence-based medical evidence. Methods. 100 patients with acute nonvariceal upper gastrointestinal bleeding (ANVUGIB) who met the clinical diagnostic criteria of ANVUGIB admitted to Suzhou First People’s Hospital from January 2017 to December 2021 were analyzed, as well as the age difference and change rule. According to age, 100 patients were divided into young (18-39 years), middle-aged (40-59 years), and elderly (60 years and above), and the differences in the three groups were compared. The etiology was confirmed by endoscopic examination and was recorded one by one in a well-designed ANVUGIB case data registration form. Statistical software SPSS 23.0 was used for analysis. Results. Gastric ulcer was the main cause in the elderly group (50.0%), duodenal ulcer was the main cause in the middle and young groups, and gastrointestinal cancer (7.1%) and marginal ulcer (2.3%) in the elderly group were higher than those in the young group. Nonsteroidal anti-inflammatory drugs (52.3%) were the main inducement in the elderly group, which was significantly higher than in the middle-aged group (13.1%) and the young group (5%) ( P < 0.01 ). Drinking, fatigue, and emotional excitement led to a higher proportion in the middle-aged group and the young group, in comparison to the elderly group ( P < 0.01 ). Conclusion. Peptic ulcer is the most common cause of acute nonvariceal upper gastrointestinal bleeding, followed by acute gastric mucosal lesions and upper digestive system tumors, compared with nonulcer.

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Section: Discussionsupporting

confidence: 92%

A Cohort Study to Compare Effects between Ulcer- and Nonulcer-Related Nonvariceal Upper Gastrointestinal Bleeding

Nian

Wang

et al. 2022

Applied Bionics and Biomechanics

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“…Pediatric LU diagnosis in emergency setting represents a complex, but interesting challenge to direct first investigations, therapy, and hospitalization. 2,13 Even though extremely rare, in the last years of COVID-19 pandemic, an increase in case reports of Fig. 3.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] This rare ulcerative condition is most frequently observed in nonsexually active girls, without association with sexually transmitted infections. [1][2][3][4] Patients typically present with flu-like symptoms followed by the sudden onset of well-demarcated, painful, vulvar ulcers with a fibrinous, purulent, or necrotic center. 1,3 These lesions usually appear in small number (≤3) on the medial surface of the labia minora and have large dimensions (>10 mm) and a symmetric mirror-like vulvar distribution ("kissing ulcers").…”

Section: Introductionmentioning

confidence: 99%

Lipschütz ulcers due to SARS-CoV-2 infection: a neglected diagnosis in emergency room

Brambilla,

Bolcato,

Volonté

et al. 2024

International Journal of Women’s Dermatology

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Background: Primary acute genital ulcers, or Lipschütz ulcers (LU), are nonsexually transmitted, painful, self-limiting, nonrecurrent vulvar ulcers with unclear pathogenesis, representing a challenging diagnosis in emergency setting. LU have recently been described in association with severe acute respiratory syndrome coronaVirus 2 (SARS-CoV-2) infection and vaccination. Objective: The aim of this study is to describe 2 cases of LU due to SARS-CoV-2 infection, highlighting the diagnostic process, differential diagnosis, disease course, and management options. Methods: We describe 2 young females (12 and 9 years old) who presented to pediatric emergency room with the sudden onset of well-demarcated, painful, vulvar ulcers with fibrinous necrotic center. Results: Both patients tested positive to SARS-CoV-2 nasal swab, and, at physical examination, no other lesions were found in other cutaneous or mucosal sites. Sexual abuse was excluded in both cases, as well as infectious and autoimmune diseases. Supportive analgesic therapy was administered, and complete remission of lesions was observed at follow-up visits without evidence of scarring. Limitations: The main limitation of this work is represented by the small number of cases described. Conclusion: Even though extremely rare, LU related to COVID-19 are an emerging entity to be considered in the diagnosis of acute genital ulcerations. Multidisciplinary diagnostic workup of genital ulcers must be established in order to exclude sexual child abuse, to ensure patient safety, and to avoid unnecessary treatment and familial anxiety.

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“…First identified in 1913 by Australian dermatologist Benjamin Lipshutz, this uncommon condition is described by sudden onset of vulvar ulcers in non-sexually active females with systemic signs of infection ( Christl et al, 2021 ). These ulcers typically present with a prodromal phase of viral symptoms including fever, fatigue, and malaise followed by 1 mm to 2.5 cm single or multiple vulvar ulcerations ( Pereira et al, 2021 ). The pathogenesis of LU is thought to be a hypersensitivity immune response to a viral or bacterial illness that results in the formation of immune complexes in the dermal vessels causing micro-thrombi that eventually lead to painful necrotizing ulcers (Moise, 2018).…”

Section: Review or Systemsmentioning

confidence: 99%