Lipschütz's acute vulvar ulcer: a systematic review

Area of Science:

• Gynecology
• Dermatology
• Infectious Diseases

Background:

• Lipschütz's acute vulvar ulceration is a rare, non-sexually transmitted condition.
• It presents as sudden-onset, painful genital ulcers in otherwise healthy individuals.
• Previously, the exact triggers and typical patient profile were not well-defined.

Purpose of the Study:

• To systematically review the clinical presentation, causes, and duration of Lipschütz's ulceration.
• To identify demographic and clinical characteristics of affected individuals.
• To understand the association with concurrent infections.

Main Methods:

• Systematic literature review of Excerpta Medica, National Library of Medicine, and Web of Science databases.
• Inclusion of case reports of Lipschütz's ulceration in previously healthy females.
• Data extraction on demographics, clinical findings, microbiological data, and treatment outcomes.

Main Results:

• 158 cases were identified, predominantly affecting females ≤20 years old (90%), mostly sexually inactive.
• Ulcers were typically 1-3, painful, ≥10 mm, well-demarcated with necrotic centers.
• Commonly associated with infectious diseases, particularly infectious mononucleosis (40 cases) and Mycoplasma infections (11 cases).
• Resolution occurred within 3 weeks; systemic corticosteroids showed no benefit.

Conclusions:

• Lipschütz's ulceration primarily affects young, often sexually inactive individuals.
• The condition is characterized by a few painful ulcers, typically linked to infections like mononucleosis.
• It resolves spontaneously within 3 weeks without recurrence.