Hospital Federal dos Servidores do Estado, Rio de Janeiro, RJ, Brazil.
Hospital Universitário Pedro Ernesto, Rio de Janeiro, RJ, Brazil.
Einstein (Sao Paulo). 2022 Feb 7;20:eRC6541. doi: 10.31744/einstein_journal/2022RC6541. eCollection 2022.
Acute vulvar ulcer (Lipschütz's ulcer) is a rare lesion with local hyperimmunoreactivity triggered by infection, which is characterized by acute, painful, and necrotic ulcerations. This condition is usually found in non-sexually active adolescents, and it resolves spontaneously. We report a case of a 35-year-old woman who was diagnosed with COVID-19 who did not have severe symptoms, but had high levels of D-dimer for 9 days. The COVID-19 diagnosis was followed by the appearance of an acute, necrotic, extremely painful vulvar ulcer, although symptoms caused by COVID-19 had improved. We emphasize the importance of the differential diagnosis to exclude diseases such as Behçet's syndrome, Sexually Transmitted Infections, as well as the presence of viruses that generally trigger Lipschütz's ulcer, such as Epstein-Barr virus and cytomegalovirus. No treatment is usually necessary, however, in the present report due to the pain experienced by the patient, we successfully used oral prednisone.
急性外阴溃疡（Lipschütz 溃疡）是一种罕见的病变，由感染引起局部高度免疫反应，表现为急性、疼痛和坏死性溃疡。这种情况通常发生在非活跃的青少年中，可自行缓解。我们报告了一例 35 岁的女性患者，她被诊断患有 COVID-19，但没有严重的症状，但 D-二聚体水平升高了 9 天。COVID-19 诊断后出现急性、坏死性、极度疼痛的外阴溃疡，尽管 COVID-19 的症状有所改善。我们强调鉴别诊断的重要性，以排除白塞病、性传播感染等疾病，以及通常引发 Lipschütz 溃疡的病毒的存在，如 Epstein-Barr 病毒和巨细胞病毒。通常不需要治疗，但在本报告中，由于患者的疼痛，我们成功地使用了口服泼尼松。
