de Castro Coelho Filipa, Amaral Maria, Correia Lúcia, Nunes Campos Maria João, Paula Tereza, Borges Augusta, Borrego Jorge
Gynecology Department, Hospital Dr. Nélio Mendonça, Serviço de Saúde da Região Autónoma da Madeira, EPE, Funchal, Portugal.
Internal Medicine Department, Maternidade Dr. Alfredo da Costa, Centro Hospitalar Lisboa Central, Lisboa, Portugal.
Case Rep Obstet Gynecol. 2018 Jun 3;2018:3507484. doi: 10.1155/2018/3507484. eCollection 2018.
Genital ulcers are challenging to any clinician and causes transcend many specialties. Skin ulceration in patients with primary Sjögren's syndrome is infrequent but an established feature of cutaneous involvement. Although gynecological symptoms, such as vulvovaginal dryness, dyspareunia, and pruritus, are common in women with primary Sjögren's syndrome, patients affected by vulvar ulcers are unknown. We describe an exceptional case of necrotic aphthous-type vulvar ulceration as initial presentation of primary Sjögren's syndrome that was possibly triggered by an infectious agent. Successful healing was achieved with oral corticosteroids, despite some loss of labia and labia as sequelae of the necrotizing process. Reactive acute genital ulcers (Lipschütz ulcers) should be considered as a possible manifestation of many autoimmune/inflammatory disorders, beyond the classic associations such as Behçet's syndrome or Crohn's disease.
生殖器溃疡对任何临床医生来说都是一项挑战，其病因涉及多个专业领域。原发性干燥综合征患者出现皮肤溃疡的情况并不常见，但却是皮肤受累的一个既定特征。虽然妇科症状，如外阴阴道干燥、性交困难和瘙痒，在原发性干燥综合征女性患者中很常见，但受外阴溃疡影响的患者却鲜为人知。我们描述了一例坏死性口疮样外阴溃疡作为原发性干燥综合征初始表现的特殊病例，该溃疡可能由一种感染因子引发。尽管坏死过程导致阴唇部分缺失，但口服皮质类固醇仍使溃疡成功愈合。反应性急性生殖器溃疡（利普许茨溃疡）应被视为许多自身免疫/炎症性疾病的一种可能表现，而非仅局限于如白塞病或克罗恩病等经典关联疾病。
