Lipschütz ulcer:

Acute Genital Ulcer in a Young Girl

“…Lipschütz ulcer or ulcus vulvae acutum is an uncommon and probably underdiagnosed entity characterized by an acute, painful vulvar ulceration of non-venereal origin. [1][2][3][4][5][6] It is considered to be more common in adolescents or young women, who frequently are virgins, but several cases have also been reported in children. [1][2][3][4][5][6] The etiology remains unknown.…”

“…In recent years these ulcers have been related to infectious agents, including Epstein-Barr virus (EBV), Mycoplasma pneumoniae, Cytomegalovirus and influenza A. [1][2][3][4][5][6] However, the mechanisms that lead to the formation of ulcers distant to the site of primary infection are poorly understood. 1 Lipschütz ulcer presents as a sudden onset of painful vulvar ulcers, single or multiple, with raised, sharply demarcated borders and a necrotic and/or fibrinous center covered by grey exsudate or grey-black eschar.…”

“…4 Bilateral "kissing lesions" (a mirrorlike vulvar distribution) are characteristic. 2,4,6 Systemic symptoms such as fever, myalgias, headache, diarrhea, oral aphthae, enlarged lymph nodes or respiratory symptoms may be present. 1 Revista SPDV 77 (1) 2019; Um diagnóstico incomum de úlceras genitais; Margarida Rato, Ana Sofia Borges, Ana Rodrigues, Cândida Fernandes.…”

“…The diagnosis of Lipschütz ulcer is made by exclusion, after ruling out sexually transmitted infections, Behçet syndrome, extra-genital Crohn's disease, trauma or any other specific diagnosis. [1][2][3][4][5][6] Initial workup may include complete blood cell count, bacterial culture, serologic test for syphilis, EBV, HIV, PCR assays for HSV. 4,5 Sometimes skin biopsy from an ulcer edge can be necessary to rule out other conditions, but histologic examination is not of diagnostic value because findings are nonspecific.…”

“…4,5 Treatment is mainly symptomatic, as the ulcers resolve spontaneously in a few weeks. [1][2][3][4][5][6] Empiric treatment includes sitz baths, topical anesthetic and corticosteroids and oral analgesics. 4,6 Oral antibiotics and corticosteroids can be used for selected cases.…”