Lipschütz Ulcer: A Rare Etiology Among Infants

An 11-month-old female patient presented to the pediatric emergency room, reporting a high fever and excessive crying. She began taking amoxicillin and clavulanic acid for acute otitis media five days prior. There was no record of trauma, suspected sexual abuse, or other medications involved. Physical examination showed a 7 mm ulcerative lesion on the left major labia and a symmetrical 5 mm violaceous lesion on the right major labia. Tests for herpesvirus, syphilis, HIV, Epstein-Barr virus, cytomegalovirus, and Mycoplasma pneumoniae all returned negative results. She was discharged with symptomatic treatment. She had no fever after one day, and the ulcers resolved four weeks later. During the one-month follow-up, the complete resolution of the ulcers confirmed the diagnosis of Lipschütz ulcer, a diagnosis based on exclusion. Lipschutz ulcer is a rare, self-limited condition that does not transmit sexually. It presents with the sudden appearance of painful, necrotic ulcers on the vulva or lower vagina. This condition mainly affects sexually inactive adolescent girls or young women and is extremely uncommon in children.