Medicine:Lipschütz ulcer
| Lipschütz ulcer | |
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| One of the first published cases of Lipschütz ulcer[1] |
Lipschütz ulcer, ulcus vulvae acutum or reactive non-sexually related acute genital ulcers (English: acute ulceration of the vulva) is a rare disease characterized by painful genital ulcers, fever, and lymphadenopathy, occurring most commonly, but not exclusively, in adolescents and young women.[2] Previously, it was described as being more common in virgins.[3] It is not a sexually transmitted infection, and is often misdiagnosed,[4][5] sometimes as a symptom of Behçet's disease.[6]
Lipschütz ulcer is named after Benjamin Lipschütz, who first described it in 1912.[1][5] The cause is still unknown, although it has been associated with several infectious causes, including paratyphoid fever, cytomegalovirus, Mycoplasma pneumoniae and Epstein–Barr virus infection[7][8][9][10]
Signs and symptoms
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.[11] 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.[11]
Diagnosis
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.[7]
Treatment
Treatment is symptomatic, and usually of little value; in most cases, the ulcer heals spontaneously within four to six weeks, sometimes leaving scars. Topical analgesics and anesthetics, as well as topical application of disinfectants/astringents such as potassium permanganate (in sitz baths), is commonly used.[11] In severe cases, a combination of systemic glucocorticoids and broad-spectrum antibiotics has been recommended.[citation needed]
Epidemiology
The disorder typically appears among young girls and adolescents but cases in children as young as 17 months have been reported.[7]
History
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][5]
See also
- Vulvovaginal health
References
- ↑ 1.0 1.1 1.2 1.3 Lipschütz B (October 1912). "Über eine eigenartige Geschwürsform des weiblichen Genitales (Ulcus vulvae acutum)" (in de). Arch Dermatol Res 114 (1): 363–96. doi:10.1007/BF01973166. https://scholar.archive.org/work/b6v6wnb2fzearlwbr4xq3gimle/access/ia_file/crossref-pre-1923-scholarly-works/10.1007%252Fbf01963479.zip/10.1007%252Fbf01973166.pdf.
- ↑ Vieira-Baptista, Pedro; Lima-Silva, Joana; Beires, Jorge; Martinez-de-Oliveira, José (2016-03-01). "Lipschütz ulcers: should we rethink this? An analysis of 33 cases". European Journal of Obstetrics, Gynecology, and Reproductive Biology 198: 149–152. doi:10.1016/j.ejogrb.2015.07.016. ISSN 1872-7654. PMID 26297242.
- ↑ "Ulcus vulvae acutum". Acta Dermatovenereologica Alpina, Pannonia et Adriatica 9 (1). 2000. ISSN 1581-2979. http://ibmi.mf.uni-lj.si/acta-apa/acta-apa-00-1/torok.html.
- ↑ "[Lipschütz acute genital ulcer]" (in fr). J Gynecol Obstet Biol Reprod (Paris) 38 (6): 528–30. October 2009. doi:10.1016/j.jgyn.2009.08.005. PMID 19744804.
- ↑ 5.0 5.1 5.2 Lipschütz' ulcer at Who Named It? Retrieved on 2009-12-04.
- ↑ "Erkrankungen des weiblichen Genitales" (in de). Dermatologie und Venereologie. Berlin: Springer. 2005. pp. 1030. ISBN 978-3-540-40525-2.
- ↑ 7.0 7.1 7.2 "Lipschütz ulcer in a 17-month-old girl: a rare manifestation of Epstein-Barr primoinfection". Eur. J. Pediatr. 172 (8): 1121–3. May 2013. doi:10.1007/s00431-013-2013-8. PMID 23636284.
- ↑ "Lipschütz genital ulceration: a rare manifestation of paratyphoid fever". Eur J Dermatol 13 (3): 297–8. 2003. PMID 12804994.
- ↑ "Lipschütz acute vulval ulcers associated with primary cytomegalovirus infection". Pediatr Dermatol 25 (1): 113–5. 2008. doi:10.1111/j.1525-1470.2007.00597.x. PMID 18304169.
- ↑ Vieira-Baptista, Pedro; Machado, Luísa; Costa, Ana Rosa; Beires, Jorge; Martinez-de-Oliveira, José (2013-07-01). "Mycoplasma pneumoniae: a rare cause of vulvar ulcers or an undiagnosed one?". Journal of Lower Genital Tract Disease 17 (3): 330–334. doi:10.1097/LGT.0b013e3182710896. ISSN 1526-0976. PMID 23486069.
- ↑ 11.0 11.1 11.2 Vulvar disease: a clinicopathological approach. Informa Healthcare. 2007. pp. 51–2. ISBN 978-0-8493-3793-2. https://books.google.com/books?id=-u8ki9L4HL0C&pg=PT65.
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