Wolters Vera, Hoogslag Isabella, Van' T Wout Jan, Boers Kim
Departments of Gynecology and Obstetrics and Internal Medicine, Haaglanden Medical Center location Bronovo, The Hague, Academic Medical Center, Amsterdam, and the Department of Infectious Diseases and Immunology, Leiden University Medical Center, Leiden, the Netherlands.
Obstet Gynecol. 2017 Aug;130(2):420-422. doi: 10.1097/AOG.0000000000002145.
Lipschütz ulcers are characterized by painful vulvar ulceration, most commonly in young women. Because these lesions are so rarely seen, the diagnosis can be challenging.
An 18-year-old woman, without any prior sexual activity, developed painful blue vulval lesions. These became necrotizing ulcers, and she began antiviral therapy for presumptive herpes infection. Herpes cultures, however, were negative. Serology consistent with a recent Epstein-Barr virus infection resulted in a diagnosis of Lipschütz ulcers.
Lipschütz ulcers, associated with acute Epstein-Barr virus infection or other viral and bacterial infections, are a type of nonsexually transmitted vulvar ulceration. It is important to avoid selective attention to sexually transmitted infections as the etiology to avoid unnecessary antiviral therapy and immune suppressants. By considering other etiologies, the patient will be spared potentially embarrassing persistent questioning about her sexual history.
利普许茨溃疡的特征是外阴疼痛性溃疡，最常见于年轻女性。由于这些病变极为罕见，诊断可能具有挑战性。
一名18岁女性，既往无任何性活动史，出现了疼痛性外阴蓝色病变。这些病变发展为坏死性溃疡，她开始接受抗病毒治疗，怀疑是疱疹感染。然而，疱疹培养结果为阴性。与近期爱泼斯坦-巴尔病毒感染相符的血清学检查结果确诊为利普许茨溃疡。
利普许茨溃疡与急性爱泼斯坦-巴尔病毒感染或其他病毒及细菌感染相关，是一种非性传播的外阴溃疡。重要的是避免将性传播感染作为病因进行选择性关注，以避免不必要的抗病毒治疗和免疫抑制剂使用。通过考虑其他病因，患者将避免因持续询问其性病史而可能产生的尴尬。
