LIPSCHUTZ GENITAL ULCERATION

By Gary M. White, MD


Lipschutz genital ulceration (LGU), also called genital aphthosis and nonsexual acute genital ulceration is characterized by the development of painful vulvar ulceration in teenage girls. Case reports have associated it with various infections including Epstein-Barr Virus, Mycoplasma fermentans [JAMA Derm 2015;151;1388] and Lyme Disease [JAMA Derm 2014;150;1202].

Clinical

The onset is acute, frequently with fever, of multiple vulvar ulcers, often covered with a dirty, firmly adherent membrane that separates in a few days. Rarely, males with EBV infection develop a penile ulcer. Serologic testing showing a recent EBV infection is helpful.

Workup

Workup should include RPR, viral culture, EBV serology, swab for culture, e.g. Haeophilus ducreyi, Neisseria gonorrhea and yeast as well as Lyme serology. The association with Mycoplasma fermentans infection in 3 young female patients [JAMA Derm 2015;151;1388] might suggest ordering IgM serology for M fermentans.

Treatment

References

Progress in Obstet and Gyn 2011:54

JAAD 2011;63;44–51

JAAD 2004;51:824–826

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