Lipschütz ulcer as a possible initial manifestation of Epstein-Barr virus infection

Authors

  • Juliana Raquel da Costa Maciel Department of Pediatrics, Hospital de Santo André, Centro Hospitalar de Leiria http://orcid.org/0000-0003-4711-8842
  • Katarina Kieselová Department of Dermatology, Hospital de Santo André, Centro Hospitalar de Leiria
  • Victoria Guiote Department of Dermatology, Hospital de Santo André, Centro Hospitalar de Leiria
  • Martinha Henrique Department of Dermatology, Hospital de Santo André, Centro Hospitalar de Leiria
  • Teresa Rezende Department of Pediatrics, Hospital de Santo André, Centro Hospitalar de Leiria

DOI:

https://doi.org/10.25753/BirthGrowthMJ.v27.i1.9847

Keywords:

Child, Epstein-Barr Virus Infections, Vulvar Diseases

Abstract

Introduction: Lipschütz ulcer is characterized by the rapid onset of painful vulvar ulcerations that typically occurs in sexually inactive adolescent girls, being rare in young children. Although the etiology is unknown, several reports suggest that this entity may be a clinical manifestation of primary infection with Epstein- Barr virus. The diagnosis is made after excluded autoimmune causes, sexually transmitted infections and genital trauma.
Case Report: A twelve-month-old girl, admitted with a history of high fever, vulvar ulceration and acute otitis media. Laboratory investigation, demonstrated an acute Epstein-Barr virus infection and ruled out other causes of acute genital ulceration, including autoimmune diseases. Clinical improvement was observed, with resolution of the genital lesions after six weeks, and no recurrence during the ten-month follow-up.
Comments: In conclusion if the most common causes of genital ulcer are excluded and there is no sexual contact, Lipschütz ulcer should be included in the differential diagnosis.

Author Biographies

Juliana Raquel da Costa Maciel, Department of Pediatrics, Hospital de Santo André, Centro Hospitalar de Leiria

Serviço de Pediatria do Centro Hospitalar de Leiria

Katarina Kieselová, Department of Dermatology, Hospital de Santo André, Centro Hospitalar de Leiria

Serviço de Dermatologia do Centro Hospitalar de Leiria

Victoria Guiote, Department of Dermatology, Hospital de Santo André, Centro Hospitalar de Leiria

Serviço de Dermatologia do Centro Hospitalar de Leiria

Martinha Henrique, Department of Dermatology, Hospital de Santo André, Centro Hospitalar de Leiria

Serviço de Dermatologia do Centro Hospitalar de Leiria

Teresa Rezende, Department of Pediatrics, Hospital de Santo André, Centro Hospitalar de Leiria

Serviço de Pediatria do Centro Hospitalar de Leiria

References

Lipschutz B. Ulcus vulvae acutum. Handbuch der Haut und Geschl. 1927; 21:392-414.

Sidbury R, Levy M. Acute genital ulceration (Lipschutz ulcer). UpToDate. 2014 Sep.

Reymundo M, Salas A. Úlcera de Lipschutz: causa poco conocida de úlcera genital aguda. An Pediatr. 2010; 72: 443-4.

Farhi D, Wendling J, Molinari E, et al. Non-sexually related acute genital ulcers in 13 pubertal girls: a clinical and microbiological study. Arch Dermatol 2009; 145:38.

Jerdan K, Aronson I, Hernandez C, et al. Genital ulcers associated with Epstein-Barr vírus. Cutis 2013; 91:273.

Marcus S, Neill S. Unusual presentation of acute vulvar ulceration. Trends in Urology Gynaecology & Sexual Health. 2008.

Brinca A, Canelas M, Carvalho M. Lipschutz ulcer (ulcus vulvae acutum) – uma causa rara de lesão genital. An Bras Dermatol. 2012; 87:622-4.

Taylor S, Droke SM, Dedicoat M. Genital ulcers associated with acute Epstein-Barr virus infection. Sex Transm Infect. 1998; 74:296-7.

Halvorsen JA, Brevig T. Genital ulcers as initial manifestation of Epstein-Barr vírus infection: two new cases and a review of the literature. Acta Derm Venereol. 2006; 86:439-42

Sárdy M, Wollenberg A, Niedermeler A. Genital ulcers associated with Epstein-Barr vírus infection (Ulcus Vulvae Acutum). Acta Derm Venereol 2011; 91:55-9.

Published

2018-04-13

How to Cite

Maciel, J. R. da C., Kieselová, K., Guiote, V., Henrique, M., & Rezende, T. (2018). Lipschütz ulcer as a possible initial manifestation of Epstein-Barr virus infection. NASCER E CRESCER - BIRTH AND GROWTH MEDICAL JOURNAL, 27(1), 50–53. https://doi.org/10.25753/BirthGrowthMJ.v27.i1.9847

Issue

Section

Case Reports