| 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 vulva}}) is a rare disease characterized by painful [[genital ulcer]]s, fever, and [[lymphadenopathy]], occurring most commonly, but not exclusively, in adolescents and young women.<ref>{{Cite journal|last=Vieira-Baptista|first=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 [[virginity|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 [[sexually transmitted disease]], and is often misdiagnosed,<ref name="Kluger">{{cite journal |vauthors=Kluger N, Garcia C, Guillot B |title=[Lipschütz acute genital ulcer] |language=French |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 [[Behçet's disease]].<ref name=Braun-Falco>{{cite book |chapter=Erkrankungen des weiblichen Genitales |year=2005 |title=Dermatologie und Venereologie |editors=Braun-Falco O, Plewig G, Wolff HH, Burgdorf WHC, Landthaler M |language=German |location=Berlin |publisher=Springer |pages=1030 |isbn=978-3-540-40525-2}}</ref>
Lipschütz ulcer is [[list of eponymous diseases|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=German |journal=Arch Dermatol Res |volume=114 |issue=1 |pages=363–96 |date=October 1912 |doi=10.1007/BF01973166}}</ref><ref name=whonamedit/> 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<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}}</ref><ref>{{Cite journal|last=Vieira-Baptista|first=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}}</ref>
[[File:Lipschutz_ulcer_original_image.jpg|thumb|right|Lipschütz ulcer on the vulva]]
==Signs and symptoms==
'''Lipschütz ulcer''', also known as acute genital ulceration, is a rare and non-sexually transmitted condition characterized by the sudden appearance of painful [[ulcer (dermatology)|ulcers]] on the [[vulva]]. It was first described by Benjamin Lipschütz in 1913.
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 [[vagina]] and [[urethra]]. The ulcer develops very quickly, and is usually preceded by sudden onset of fever and malaise.<ref name=Heller/>
==Diagnosis==
== Clinical Presentation ==
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.<ref name="pmid23636284"/>
==Treatment==
Lipschütz ulcers typically present as one or more painful, necrotic ulcers on the vulva. These ulcers are often accompanied by systemic symptoms such as fever, malaise, and lymphadenopathy. The ulcers are usually well-circumscribed with a necrotic base and an inflammatory halo.
Treatment is symptomatic, and usually of little value; in most cases, the ulcer heals spontaneously within four to six weeks, sometimes leaving scars. Topical [[analgesic]]s and anesthetics, as well as topical application of disinfectants/[[astringent]]s such as [[potassium permanganate]] (in [[sitz bath]]s), is commonly used.<ref name=Heller/> In severe cases, a combination of systemic [[glucocorticoid]]s and [[broad-spectrum antibiotic]]s has been recommended.
==Epidemiology==
== Etiology ==
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 |url=}}</ref>
==History==
The exact cause of Lipschütz ulcers is not well understood. However, they are often associated with viral infections, particularly [[Epstein-Barr virus]] (EBV) and [[cytomegalovirus]] (CMV). Other potential triggers include bacterial infections and stress.
The disease was first described in October 1912 by [[Galicia (eastern Europe)|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''" (''[[Lactobacillus acidophilus]]'').<ref name=Lipschutz/><ref name=whonamedit/>
==See also==
== Diagnosis ==
*[[Vulvovaginal health]]
==References==
Diagnosis of Lipschütz ulcer is primarily clinical, based on the characteristic appearance of the ulcers and the exclusion of other causes of genital ulcers, such as [[herpes simplex virus]] (HSV) infection and [[syphilis]]. Laboratory tests may include viral cultures, serology, and polymerase chain reaction (PCR) testing to rule out other infections.
{{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}}
== Treatment ==
[[Category:Gynaecologic disorders]]
[[Category:Virus-related cutaneous conditions]]
Treatment of Lipschütz ulcers is mainly supportive. Pain management is crucial and may involve the use of analgesics and topical anesthetics. In some cases, corticosteroids may be prescribed to reduce inflammation. The ulcers typically resolve spontaneously within a few weeks.
== Prognosis ==
The prognosis for Lipschütz ulcers is generally good, with most cases resolving without long-term complications. Recurrence is uncommon.
Lipschütz ulcer, also known as acute genital ulceration, is a rare and non-sexually transmitted condition characterized by the sudden appearance of painful ulcers on the vulva. It was first described by Benjamin Lipschütz in 1913.
Clinical Presentation
Lipschütz ulcers typically present as one or more painful, necrotic ulcers on the vulva. These ulcers are often accompanied by systemic symptoms such as fever, malaise, and lymphadenopathy. The ulcers are usually well-circumscribed with a necrotic base and an inflammatory halo.
Etiology
The exact cause of Lipschütz ulcers is not well understood. However, they are often associated with viral infections, particularly Epstein-Barr virus (EBV) and cytomegalovirus (CMV). Other potential triggers include bacterial infections and stress.
Diagnosis
Diagnosis of Lipschütz ulcer is primarily clinical, based on the characteristic appearance of the ulcers and the exclusion of other causes of genital ulcers, such as herpes simplex virus (HSV) infection and syphilis. Laboratory tests may include viral cultures, serology, and polymerase chain reaction (PCR) testing to rule out other infections.
Treatment
Treatment of Lipschütz ulcers is mainly supportive. Pain management is crucial and may involve the use of analgesics and topical anesthetics. In some cases, corticosteroids may be prescribed to reduce inflammation. The ulcers typically resolve spontaneously within a few weeks.
Prognosis
The prognosis for Lipschütz ulcers is generally good, with most cases resolving without long-term complications. Recurrence is uncommon.
