Lipschütz Genital Ulceration Associated with Mumps

Chanal, J.; Carlotti, A.; Laude, Hélène; Wallet-Faber, N.; Avril, Marie-Françoise; Dupin, Nicolas

doi:10.1159/000319857

Cited by 30 publications

(19 citation statements)

References 63 publications

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“…Other pathological agents have been found to be associated with episodes of AGU, including CMV, paratyphoid fever, influenza A, Toxoplasma gondii and Mycoplasma 1 – 4 7 8. Chanal et al 5 have also reported a case of AGU associated with mumps. The pathophysiological mechanism of ulcer in these cases is unknown.…”

Section: Discussionmentioning

confidence: 95%

“…LU seems to be a rare entity, because there are few cases reported in the medical literature but their true incidence is difficult to know as many cases are misdiagnosed with other more frequent causes of genital ulcers 1 5…”

Section: Discussionmentioning

confidence: 99%

“…Broad-spectrum antibiotics to cover skin flora should be considered. Use of systemic corticoids is indicated if the patient fails to respond to topical agents 1 – 5 7 9…”

Section: Discussionmentioning

confidence: 99%

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Acute genital ulcers

et al. 2014

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Acute genital ulcers, also known as acute vulvar ulcers, ulcus vulvae acutum or Lipschütz ulcers, refer to an ulceration of the vulva or lower vagina of non-venereal origin that usually presents in young women, predominantly virgins. Although its incidence is unknown, it seems a rare entity, with few cases reported in the literature. Their aetiology and pathogenesis are still unknown. The disease is characterised by an acute onset of flu-like symptoms with single or multiple painful ulcers on the vulva. Diagnosis is mainly clinical, after exclusion of other causes of vulvar ulcers. The treatment is mainly symptomatic, with spontaneous resolution in 2 weeks and without recurrences in most cases. We present a case report of a 13-year-old girl with two episodes of acute ulcers that fit the clinical criteria for Lipschütz ulcers.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

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Acute genital ulcers

et al. 2014

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“…1 Its true incidence is difficult to report both because of its rarity and misdiagnosis in favor of other more common genital ulcers. 2,3 It is characterized by sudden onset of painful ulcers of the vulva or lower vagina and typically occurs in nonsexually active young women. They are greater than 1 cm in diameter exhibiting a deep, erythematous border and necrotic base.…”

Section: Discussionmentioning

confidence: 99%

Fever, Genital Pain, and Genital Ulcers

Indra

Arora

2015

Clin Pediatr (Phila)

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A previously healthy 11-year-old female presented to the emergency department (ED) with complaints of fever, vomiting, and genital pain. Her symptoms began 4 days ago. She had fevers of up to 105°F for which she had been intermittently taking acetaminophen and ibuprofen. She had also experienced 6 episodes of nonbilious, nonbloody emesis. Three days prior to presentation, she began having sharp pain localized to the genital area. The day before her ED visit, she went to her pediatrician's office where a urinalysis and urine culture was performed. She was sent home with a presumptive diagnosis of a urinary tract infection. The same evening the patient complained of further pain in her genital area and her mother noted nonspecific staining of her underwear. Consequently, her mother brought the patient to the ED the following day.The patient had not attained menarche. She did not complain of dysuria, urgency, frequency, abdominal/ flank pain, vaginal discharge, joint pain, mouth pain/ ulcers, or rash. Two weeks ago she had shaved her pubic region, but was uncertain of having sustained any cuts to the area. She denied being sexually active. As per the history, there was no trauma and no suspicion or concern regarding sexual abuse.On presentation she was awake, alert, and in no acute distress. She was afebrile, with normal vital signs. Her abdomen was soft, nontender with no organomegaly. Her genitourinary exam revealed a 1.5-cm well-demarcated irregular ulcerated lesion on the inner aspect of her right labia minora and an adjacent 1-cm ulcerated lesion on the opposing surface of her left labia minora, both very painful to the touch. There was no active discharge or bleeding. Her hymen appeared intact and normal for age. Her perineal area appeared normal. There was no other skin or mucosal lesions. There were no signs of trauma or child abuse. There was no inguinal or other lymphadenopathy. The rest of her systemic examination was unremarkable.In the ED, initial workup revealed a white blood cell count of 14 000/µL (14.0 × 10 9 /L) with 65% neutrophils and 24% lymphocytes. Basic electrolytes panel was normal. C-reactive protein was elevated at 52.9 mg/L. Urinalysis showed a pH of 6.0, 1+ ketones, 2+ blood, 2+ leukocyte esterase, negative nitrites, <2 red blood cells, and 10 to 20 white blood cells. Urine pregnancy test was negative. A pelvic and renal ultrasound was unremarkable. A dose of ceftriaxone was administered for a possible urinary tract infection. Laboratory screening tests for sexually transmitted infections were requested, and the patient was admitted for further workup. Final DiagnosisLipschütz ulcers (acute genital ulcers) Hospital CourseSubsequent workup including Chlamydia, gonorrhea, and herpes simplex virus (HSV 1 and 2) culture and DNA amplification from the lesion, and serology test for syphilis, Epstein-Barr virus (EBV), cytomegalovirus (CMV), and HIV were all negative. Cultures from the lesion, urine, and blood are also negative; hence, antibiotics were discontinued. Ophthalmologic exam was negat...

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“…Large arrays of potentially precipitating factors have been analyzed but the exact etiology and pathomechanism are still unknown. Previous studies mainly focused on infectious agents as causative factors, including EBV [3,[9][10][11][12][13], CMV [14], mumps [17], Mycoplasma pneumoniae, salmonellosis [16] and influenza A [15]; however, in most cases, connection with infection could not be confirmed. In the majority of reported cases, the patients were regarded as immunocompetent [3,14], however, the exact immunological status of most patients was not evaluated [9].…”

Section: Discussionmentioning

confidence: 99%

Ulcus vulvae acutum Lipschütz in two young female patients

Kinyó¹,

Nagy²,

Oláh³

et al. 2014

European Journal of Dermatology

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Ulcus vulvae acutum Lipschütz in two young female patientsUlcus vulvae acutum Lipschütz or acute genital ulcer is a distinct clinical entity characterized by sudden painful genital ulceration occurring mostly in young and virgin girls with malaise, fever and other systemic symptoms. This distressing syndrome is rare and may be presented to dermatologists, gynecologists or pediatricians. Its diagnosis and therapy can be challenging. We present two young female patients with ulcus vulvae acutum. The cause of the disease could not be confirmed in our patients, but, interestingly, both patients had partial IgA deficiency. In the last 100 years, after its first description by Lipschütz, many case reports and series have aimed to identify a specific cause of the disease, without success. These studies mainly focused on infectious agents as causative factors, however, in most cases connection with infection could not be confirmed. Our opinion is that the decreased level of IgA could be a possible explanation for the cause of this syndrome. With our cases we would like to emphasize the possible role of local immunological mechanisms rather than several infectious agents in the development of this little-known disease.

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Lipschütz Genital Ulceration Associated with Mumps

Cited by 30 publications

References 63 publications

Acute genital ulcers

Acute genital ulcers

Fever, Genital Pain, and Genital Ulcers

Ulcus vulvae acutum Lipschütz in two young female patients

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