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

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.