Vulvar Ulcers in Young Females: A Manifestation of Aphthosis

Huppert, Jill S.; Gerber, Michael A.; Deitch, Helen R.; Mortensen, Joel E.; Staat, Mary Allen; Hillard, Paula J. Adams

doi:10.1016/j.jpag.2006.02.006

Cited by 104 publications

(122 citation statements)

References 22 publications

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“…Some ulcers are not acquired sexually, including aphthous spectrum ulcers and those caused by Epstein-Barr virus infection. 9 Genital warts (condylomata acuminata) can present as flat or exophytic and are attributable to human papillomavirus. Condylomata lata are flesh-colored papules on mucous membranes, which can be confused with warts but are filled with spirochetes and are a manifestation of secondary syphilis.…”

Section: Performing the Pelvic Examination And Common Findings Externmentioning

confidence: 99%

Gynecologic Examination for Adolescents in the Pediatric Office Setting

Braverman¹,

Breech²

2010

Pediatrics

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The American Academy of Pediatrics promotes the inclusion of the gynecologic examination in the primary care setting within the medical home. Gynecologic issues are commonly seen by clinicians who provide primary care to adolescents. Some of the most common concerns include questions related to pubertal development; menstrual disorders such as dysmenorrhea, amenorrhea, oligomenorrhea, and abnormal uterine bleeding; contraception; and sexually transmitted and non-sexually transmitted infections. The gynecologic examination is a key element in assessing pubertal status and documenting physical findings. Most adolescents do not need an internal examination involving a speculum or bimanual examination. However, for cases in which more extensive examination is needed, the primary care office with the primary care clinician who has established rapport and trust with the patient is often the best setting for pelvic examination. This report reviews the gynecologic examination, including indications for the pelvic examination in adolescents and the approach to this examination in the office setting. Indications for referral to a gynecologist are included. The pelvic examination may be successfully completed when conducted without pressure and approached as a normal part of routine young women's health care. Pediatrics 2010;126: 583-590 INTRODUCTIONGynecologic issues are commonly seen by clinicians who provide primary care to adolescents. Some of the most common problems include questions related to pubertal development; menstrual disorders such as dysmenorrhea, amenorrhea, oligomenorrhea, and abnormal uterine bleeding; contraception; and sexually transmitted infections (STIs) and non-STIs. Approximately one-half of adolescents attending high school have been sexually active, which places them at risk for STIs and pregnancy. 1 Younger adolescents often have questions about pubertal development, and the gynecologic examination is a key element in assessing pubertal status and documenting physical findings.The American Academy of Pediatrics (AAP) promotes the inclusion of the pelvic examination in the primary care setting within the medical home. The examination can be a positive experience when conducted without pressure and approached as a normal part of routine young women's health care. At a minimum, examination of the external genitalia should be included as part of the annual comprehensive physical examination of children and adolescents of all ages. Routinely explaining and including this examination normalizes the experience rather

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Section: Performing the Pelvic Examination And Common Findings Externmentioning

confidence: 99%

Gynecologic Examination for Adolescents in the Pediatric Office Setting

Braverman¹,

Breech²

2010

Pediatrics

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“…In addition, 10 patients reported episode of an oral aphthous ulcer. With these findings, authors concluded vulvar ulcer in these cases as a complex aphthous manifestation 16 . Epidemiology, anamnesis data and the exclusion of other etiologies should also be considered 7,10 .…”

mentioning

confidence: 67%

Lipschutz Ulcer: a literature review

Meireles¹,

Barros²,

Bello³

et al. 2017

Rev Pat Tocantins

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Initially in 1913, Lipschutz described a vulvar ulcer pattern in female adolescents with no history of sexual intercourse associated with a sudden onset, painful vulvar ulceration, and systemic prodromes. Also known as ulcus vulvae actum or acute genital ulcer, it is a reaction to an infection or an inflammation, which can be systemic or localized in a non-vulvar site. The Lipschutz ulcer (LU) is a diagnosis of exclusion and it has numerous differential diagnoses. For example, sexually transmitted infections (STIs), non-venereal diseases, drug reactions, traumatic and neoplastic causes, among others, should be considered. This study aims to review the diagnosis and treatment of LU, since this disease is often underdiagnosed and constitutes an important differential diagnosis of genital ulcers. It is important to remember that this disease has a non-specific prodromic clinical condition, presenting itself with painful ulcers in the genital region, it is not sexually transmitted, it is self-limited and the treatment is focused on analgesia for better patient ease. Keywords: acute genital ulcer, Lipschutz ulcer, vulvar ulcer. RESUMOInicialmente, em 1913, Lipschutz descreveu um padrão de úlcera vulvar em adolescentes do sexo feminino sem histórico de relações sexuais associadas a um início súbito, ulceração vulvar dolorosa e pródromos sistêmicos. Também conhecida como ulcus vulvae actum ou úlcera genital aguda, é uma reação a uma infecção ou inflamação, que pode ser sistêmica ou localizada em um sítio não vulvar. A úlcera de Lipschutz (UL) é um diagnóstico de exclusão e tem inúmeros diagnósticos diferenciais. Por exemplo, infecções sexualmente transmissíveis (ISTs), doenças não venéreas, reações a drogas, causas traumáticas e neoplásicas, entre outras, devem ser consideradas. Este estudo tem como objetivo revisar o diagnóstico e o tratamento da UL, uma vez que esta doença é frequentemente subdiagnosticada e constitui um importante diagnóstico diferencial de úlceras genitais. É importante lembrar que esta doença possui uma condição clínica prodrômica não específica, apresentando úlceras dolorosas na região genital, não é sexualmente transmitida, é autolimitada e o tratamento é focado na analgesia para um melhor conforto do paciente. Palavras-chave: Úlcera genital aguda, Úlcera de Lipschutz, Úlcera vulvar.Revista de Patologia do Tocantins 2017; 4(3): 80-82.

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“…Other pathological agents have been found to be associated with episodes of AGU, including CMV [34,35,36] in 4 cases and Toxoplasma gondii in 1 case [37]. One case of cold haemagglutinin associated with mycoplasma infection and AGU has also been described [38], and a case of AGU following influenza A infection has recently been reported [39].…”

Section: Reviewmentioning

confidence: 99%

Lipschütz Genital Ulceration Associated with Mumps

Chanal

Carlotti²,

Laude³

et al. 2010

Dermatology

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Lipschütz ulcers are characterised by a first flare of non-sexually related acute genital ulcers (AGU) occurring in adolescent girls. Epstein-Barr primary infection is the most frequently reported aetiology but other infectious agents are probably implicated. We report the first case of mumps associated with an AGU in a 21-year-old girl. She presented a bilateral parotitis with genital ulcers, and serology confirmed she had mumps. As in our case, most Lipschütz ulcers heal spontaneously within a couple of weeks and the diagnosis should be reconsidered in case of recurrence.

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Vulvar Ulcers in Young Females: A Manifestation of Aphthosis

Cited by 104 publications

References 22 publications

Gynecologic Examination for Adolescents in the Pediatric Office Setting

Gynecologic Examination for Adolescents in the Pediatric Office Setting

Lipschutz Ulcer: a literature review

Lipschütz Genital Ulceration Associated with Mumps

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