Pediatric Institute of Southern Switzerland, Ospedale San Giovanni, Bellinzona, Switzerland.
Pediatric Cardiology Unit, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland.
Eur J Pediatr. 2020 Oct;179(10):1559-1567. doi: 10.1007/s00431-020-03647-y. Epub 2020 Apr 15.
In previously healthy subjects, vulvar ulcers are mostly caused by sexually transmitted microorganisms. Lipschütz's acute vulvar ulceration, first reported in 1912, is a non-sexually acquired condition characterized by sudden onset of a few genital ulcers. We systematically review presentation, underlying causes, and disease duration of Lipschütz's ulceration. A comprehensive source of Excerpta Medica, National Library of Medicine, and Web of Science databases was performed. Reports including cases of apparently previously healthy females affected by Lipschütz's ulceration were selected. A predefined database was used to extract data on demographics, history, clinical and microbiological findings, and treatment.The search disclosed 158 cases. Almost 90% of cases were ≤ 20 years of age and sexually inactive. Lesions were usually one to about three, painful, ≥ 10 mm large, well-delimited, with a fibrinous and necrotic center and a symmetric distribution. Voiding disorders and enlarged inguinal lymph nodes were observed in a large subset of cases. Canker sores were noted in 10% of patients. Lipschütz's vulvar ulceration occurred concomitantly with an infectious disease in 139 cases. Infectious mononucleosis syndrome (N = 40) was the most frequently detected well-defined infection, followed by mycoplasma species infections (N = 11). The disease resolved after ≤ 3 weeks.Conclusions: Lipschütz's ulceration mainly affects both sexually inactive and, less frequently, sexually active subjects ≤ 20 years of age, presents with ≤ 3 vulvar ulcers, resolves without recurrences within 3 weeks and is temporarily associated with an infection, most frequently a flu-like illness or an infectious mononucleosis syndrome. What is Known: • Lipschütz's acute vulvar ulceration is a non-sexually acquired condition, which is characterized by a sudden onset of a few necrotic and painful genital ulcers. • The condition tends to resolve spontaneously and is usually triggered by an infection. What is New: • The condition mainly affects subjects ≤ 20 years of age, tends to resolve within 3 weeks, and is usually temporarily associated with a flu-like illness or an infectious mononucleosis syndrome. • Systemic corticosteroids do not reduce disease duration.
在既往健康的人群中，外阴溃疡主要由性传播微生物引起。1912 年首次报道的 Lipschütz 急性外阴溃疡是非性传播获得性疾病，其特征为突然出现少数生殖器溃疡。我们系统地回顾了 Lipschütz 溃疡的表现、潜在病因和疾病持续时间。我们对 Excerpta Medica、美国国家医学图书馆和 Web of Science 数据库进行了全面检索。选择了包括明显既往健康的女性受 Lipschütz 溃疡影响的病例报告。使用预定义的数据库提取人口统计学、病史、临床和微生物学发现以及治疗数据。该检索共发现 158 例病例。近 90%的病例年龄≤20 岁且无性生活，病变通常为 1 至 3 个，疼痛，≥10mm 大，界限清楚，中心有纤维蛋白和坏死，分布对称。大多数情况下会出现排尿障碍和腹股沟淋巴结肿大。10%的患者有口疮。139 例 Lipschütz 外阴溃疡同时伴有传染病。传染性单核细胞增多症综合征（N=40）是最常发现的明确感染，其次是支原体感染（N=11）。疾病在≤3 周内缓解。结论：Lipschütz 溃疡主要影响无性生活和性生活较少的≤20 岁的人群，表现为≤3 个外阴溃疡，在 3 周内无复发自行缓解，且与感染暂时相关，最常见的是流感样疾病或传染性单核细胞增多症。已知：• Lipschütz 急性外阴溃疡是非性传播获得性疾病，其特征为突然出现少数坏死和疼痛的生殖器溃疡。• 这种疾病倾向于自发缓解，通常由感染引发。新发现：• 这种疾病主要影响≤20 岁的人群，通常在 3 周内缓解，且通常与流感样疾病或传染性单核细胞增多症暂时相关。• 全身皮质类固醇不能缩短疾病持续时间。
