View source for Medicine:Lipschütz ulcer

{{Infobox medical condition (new)
| name            = Lipschütz ulcer
| synonyms        =
| image           = Lipschutz ulcer original image.jpg
| caption         = One of the first published cases of Lipschütz ulcer<ref name=Lipschutz/>
| pronounce       =
| field           =
| symptoms        =
| complications   =
| onset           =
| duration        =
| types           =
| causes          =
| risks           =
| diagnosis       =
| differential    =
| prevention      =
| treatment       =
| medication      =
| prognosis       =
| frequency       =
| deaths          =
}}
'''Lipschütz ulcer,''' '''''ulcus vulvae acutum''''' or '''reactive non-sexually related acute genital ulcers''' ({{lang-en|acute ulceration of the [[Medicine:Vulva|vulva]]}}) is a rare disease characterized by painful genital ulcers, fever, and [[Medicine:Lymphadenopathy|lymphadenopathy]], occurring most commonly, but not exclusively, in adolescents and young women.<ref>{{Cite journal|last1=Vieira-Baptista|first1=Pedro|last2=Lima-Silva|first2=Joana|last3=Beires|first3=Jorge|last4=Martinez-de-Oliveira|first4=José|date=2016-03-01|title=Lipschütz ulcers: should we rethink this? An analysis of 33 cases|journal=European Journal of Obstetrics, Gynecology, and Reproductive Biology|volume=198|pages=149–152|doi=10.1016/j.ejogrb.2015.07.016|issn=1872-7654|pmid=26297242}}</ref> Previously, it was described as being more common in virgins.<ref name="Torok">{{cite journal |vauthors=Török L, Domján K, Faragó E |title=Ulcus vulvae acutum |journal=Acta Dermatovenereologica Alpina, Pannonia et Adriatica |year=2000 |volume=9 |issue=1 |issn=1581-2979 |url=http://ibmi.mf.uni-lj.si/acta-apa/acta-apa-00-1/torok.html}}</ref> It is not a [[Medicine:Sexually transmitted infection|sexually transmitted infection]], and is often misdiagnosed,<ref name="Kluger">{{cite journal |vauthors=Kluger N, Garcia C, Guillot B |title=[Lipschütz acute genital ulcer] |language=fr |journal=J Gynecol Obstet Biol Reprod (Paris) |volume=38 |issue=6 |pages=528–30 |date=October 2009 |pmid=19744804 |doi=10.1016/j.jgyn.2009.08.005}}</ref><ref name="whonamedit">{{WhoNamedIt|synd|2265|Lipschütz' ulcer}} Retrieved on 2009-12-04.</ref> sometimes as a symptom of [[Medicine:Behçet's disease|Behçet's disease]].<ref name=Braun-Falco>{{cite book |chapter=Erkrankungen des weiblichen Genitales |year=2005 |title=Dermatologie und Venereologie |veditors=Braun-Falco O, Plewig G, Wolff HH, Burgdorf WH, Landthaler M |language=de |location=Berlin |publisher=Springer |pages=1030 |isbn=978-3-540-40525-2}}</ref>

Lipschütz ulcer is named after Benjamin Lipschütz, who first described it in 1912.<ref name=Lipschutz>{{cite journal |author=Lipschütz B |title=Über eine eigenartige Geschwürsform des weiblichen Genitales (Ulcus vulvae acutum) |language=de |journal=Arch Dermatol Res |volume=114 |issue=1 |pages=363–96 |date=October 1912 |doi=10.1007/BF01973166|s2cid=11890180 |url= https://scholar.archive.org/work/b6v6wnb2fzearlwbr4xq3gimle/access/ia_file/crossref-pre-1923-scholarly-works/10.1007%252Fbf01963479.zip/10.1007%252Fbf01973166.pdf }}</ref><ref name=whonamedit/> The cause is still unknown, although it has been associated with several infectious causes, including [[Medicine:Paratyphoid fever|paratyphoid fever]], [[Biology:Cytomegalovirus|cytomegalovirus]], ''Mycoplasma pneumoniae'' and [[Biology:Epstein–Barr virus|Epstein–Barr virus]] infection<ref name="pmid23636284"/><ref name="Pelletier">{{cite journal  |vauthors=Pelletier F, Aubin F, Puzenat E, etal |title=Lipschütz genital ulceration: a rare manifestation of paratyphoid fever |journal=Eur J Dermatol |volume=13 |issue=3 |pages=297–8 |year=2003 |pmid=12804994}}</ref><ref>{{cite journal |vauthors=Martín JM, Godoy R, Calduch L, Villalon G, Jordá E |title=Lipschütz acute vulval ulcers associated with primary cytomegalovirus infection |journal=Pediatr Dermatol |volume=25 |issue=1 |pages=113–5 |year=2008 |pmid=18304169 |doi=10.1111/j.1525-1470.2007.00597.x|s2cid=23743938 }}</ref><ref>{{Cite journal|last1=Vieira-Baptista|first1=Pedro|last2=Machado|first2=Luísa|last3=Costa|first3=Ana Rosa|last4=Beires|first4=Jorge|last5=Martinez-de-Oliveira|first5=José|date=2013-07-01|title=Mycoplasma pneumoniae: a rare cause of vulvar ulcers or an undiagnosed one?|journal=Journal of Lower Genital Tract Disease|volume=17|issue=3|pages=330–334|doi=10.1097/LGT.0b013e3182710896|issn=1526-0976|pmid=23486069|s2cid=145823}}</ref>

==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.<ref name=Heller>{{cite book |vauthors=Heller DS, Wallach RC |title=Vulvar disease: a clinicopathological approach |publisher=Informa Healthcare |year=2007 |pages=51–2 |isbn=978-0-8493-3793-2 |url=https://books.google.com/books?id=-u8ki9L4HL0C&pg=PT65}}</ref> The labia majora may be affected, as may the [[Biology:Vagina|vagina]] and urethra. The ulcer develops very quickly, and is usually preceded by sudden onset of fever and malaise.<ref name=Heller/>

==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 [[Biology:Polymerase chain reaction|polymerase chain reaction]] for virus genome can help to reach sooner a diagnosis.<ref name="pmid23636284"/>

==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 [[Biology:Analgesic|analgesic]]s and anesthetics, as well as topical application of disinfectants/astringents such as [[Chemistry:Potassium permanganate|potassium permanganate]] (in sitz baths), is commonly used.<ref name=Heller/> In severe cases, a combination of systemic [[Chemistry:Glucocorticoid|glucocorticoid]]s and [[Chemistry:Broad-spectrum antibiotic|broad-spectrum antibiotic]]s has been recommended.{{cn|date=May 2021}}

==Epidemiology==
The disorder typically appears among young girls and adolescents but cases in children as young as 17 months have been reported.<ref name="pmid23636284">{{cite journal |vauthors=Burguete Archel E, Ruiz Goikoetxea M, Recari Elizalde E, Beristain Rementería X, Gómez Gómez L, Iceta Lizarraga A |title=Lipschütz ulcer in a 17-month-old girl: a rare manifestation of Epstein-Barr primoinfection |journal=Eur. J. Pediatr. |volume= 172|issue= 8|pages= 1121–3|date=May 2013 |pmid=23636284 |doi=10.1007/s00431-013-2013-8 |s2cid=189872655 |doi-access=free }}</ref>

==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.<ref name=Lipschutz/> He initially ascribed the ulcer to infection with "''Bacillus crassus''" (''[[Biology:Lactobacillus acidophilus|Lactobacillus acidophilus]]'').<ref name=Lipschutz/><ref name=whonamedit/>

==See also==
* Vulvovaginal health

==References==
{{Reflist}}
== External links ==
{{Medical resources
|  DiseasesDB     =
|  ICD10          =
|  ICD9           = {{ICD9|616.50}}
|  ICDO           =
|  OMIM           =
|  MedlinePlus    =
|  eMedicineSubj  =
|  eMedicineTopic =
|  MeshID         =
}}
{{Diseases of the pelvis and genitals}}

{{DEFAULTSORT:Lipschutz Ulcer}}
[[Category:Rare diseases]]

{{Sourceattribution|Lipschütz ulcer}}