Acutal ulcerN76.6
Synonym(s)
acutal ulcer; acute vulvar ulcer; Lip protection genital ulceration
HistoryThis section has been translated automatically.
Lip contactor, 1913
DefinitionThis section has been translated automatically.
Acutely occurring ulcerations in the genital area of younger women of unknown etiology.
ClassificationThis section has been translated automatically.
Diagnostic Criteria:
- Major criteria (both must be met):
- Acute onset
- Exclusion of other causes
- Minor criteria (at least 2 pieces)
- Vestibule or labia minora affected
- Virgo or last GV more than 3 months ago
- General flu symptoms
- Systemic infection in the last 2-4 weeks
EtiopathogenesisThis section has been translated automatically.
Triggers discussed are viral infections (in 30% evidence of an acute EBV infection), mixed bacterial infections, poor hygiene. Occurrence in underlying diseases such as Behçet 's disease or atypical pneumonia has also been described.
ManifestationThis section has been translated automatically.
Especially with younger women, also with infants and toddlers.
Clinical featuresThis section has been translated automatically.
- Chronic form: Recurrent ulcerations of varying size, slowly healing, especially in the region of the vaginal introitus and the labia majora.
- Gangrenous form: Rapidly growing, scab-covered, painful, possibly perforating, scarring healing ulcerations on the labia minora. Acute onset, fever, regional swelling of lymph nodes.
- Miliary form: small ulcerations on the border of the greater labia, on the perineum and the lesser labia.
- Histology: lymphocytic vasculitis
Differential diagnosisThis section has been translated automatically.
General therapyThis section has been translated automatically.
Physical rest and bed rest.
External therapyThis section has been translated automatically.
For small ulcerations, external antiseptic or antibiotic therapy is sufficient. Sitting baths with disinfecting additives such as quinolinol (e.g. Chinosol 1:1000, R042 ), potassium permanganate (light pink) are helpful. In addition, brushing with disinfectant solutions such as Polyvidon-Iodine Solution R203 and ointment dressings with Polyvidon-Iodine Ointment (e.g. Braunovidone-Iodine) should be used. In case of accompanying intertrigo, brushing with drying aqueous disinfectant solutions (e.g. 0.5% methylrosanilinium chloride solution [gentian violet]) is indicated.
Internal therapyThis section has been translated automatically.
In the case of extensive ulcerations and severe clinical progressions, antibiotic administration after antibiogram, possibly also short-term in combination with systemic glucocorticoids such as prednisolone equivalent (e.g. Solu Decortin H) 40-60 mg/day in decreasing doses.
LiteratureThis section has been translated automatically.
- Chen W et al. (2019) Lipschütz genital ulcer revisited: is juvenile gangrenous vasculitis of the scrotum the male counterpart? Journal of the European Academy of Dermatology and Venereology 33.9: 1660-1666.
- Korting GW et al (1979) Ulcus vulvae acutum with cold agglutinin-positive, mycoplasma-related atypical pneumonia. Dermatologist 30: 550-552
- Lipschütz B (1913) On a peculiar form of ulceration of the female genitalia (ulcus vulvae acutum). Arch Dermatol Syphilis (Vienna) 114: 363-395
- Lipschütz B (1918) On vulvae acutum. Wiener klin Wochenschr 31: 461-464
- Pelletier F et al (2003) Lipschutz genital ulceration: a rare manifestation of paratyphoid fever. Eur J Dermatol 13: 297-298
- Torok L et al (2000) Ulcus vulvae acutum. Cutis 65: 387-389