Department of Dermatology, University of Illinois Chicago College of Medicine, Chicago, Illinois, USA.
Dermatol Online J. 2023 Dec 15;29(6). doi: 10.5070/D329663000.
There is a rare subset of non-sexually acquired acute genital ulcers, previously called Lipschutz ulcers, that are often preceded by a constitutional prodrome and have been associated with multiple viral and bacterial infections. These ulcers are categorized by some as a variant of complex aphthosis, with one hypothesized etiology involving a non-specific systemic inflammatory response to acute infection or vaccination. Although painful, these lesions resolve over the course of several weeks and recurrence is rare but possible. Recently, there have been reports of genital ulcer development due to either acute infection with COVID-19 or following vaccination against the same. We report a case of non-sexually acquired acute genital ulceration that initially presented in 2008 as Lipschutz labial ulcers associated with acute Epstein-Barr virus infection, with recurrence twelve years later following administration of the second dose of the Pfizer-BioNTech COVID-19 vaccine. This case report and exhaustive literature review challenges widely accepted views regarding the typical age range of patients affected by non-sexually acquired acute genital ulceration, the sexual history of affected populations, the pathophysiology of lesion occurrence, and possibility of lesion recurrence.
有一种罕见的非性传播获得性急性生殖器溃疡，以前称为 Lipschutz 溃疡，常伴有全身前驱症状，并与多种病毒和细菌感染有关。这些溃疡被一些人归类为复发性阿弗他溃疡的一种变异型，一种假设的病因涉及对急性感染或疫苗接种的非特异性全身炎症反应。虽然这些病变很痛，但会在数周内愈合，且很少复发。最近，有报道称生殖器溃疡的发生是由于急性感染 COVID-19 或接种针对该病毒的疫苗。我们报告了一例非性传播获得性急性生殖器溃疡，该患者最初于 2008 年表现为与急性 EBV 感染相关的 Lipschutz 唇溃疡，12 年后在接种第二剂辉瑞-生物技术公司的 COVID-19 疫苗后复发。这个病例报告和详尽的文献回顾挑战了关于非性传播获得性急性生殖器溃疡患者的典型年龄范围、受影响人群的性史、病变发生的病理生理学以及病变复发可能性的广泛接受的观点。
