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Lipschütz Ulcer: A Rare Etiology Among Infants
Mariana S Pedro1, Marta Caldas1, Jorge Penas1
1Pediatrics, Centro Hospitalar do Oeste, Unidade Caldas da Rainha, Caldas da Rainha, PRT.
Insights
Lipschütz ulcer, a rare condition causing painful vulvar ulcers, was diagnosed in an infant. This self-limited condition resolved spontaneously without specific treatment, highlighting its non-sexually transmitted nature.
Area of Science:
- Pediatric Dermatology
- Gynecology
Background:
- Lipschütz ulcer is a rare, self-limited condition characterized by sudden onset of painful, necrotic vulvar or vaginal ulcers.
- It primarily affects sexually inactive adolescent girls and young women, making it extremely uncommon in infants.
Observation:
- An 11-month-old female presented with fever and crying, later found to have ulcerative lesions on the labia majora.
- Extensive testing for infectious etiologies, including herpesvirus, syphilis, HIV, Epstein-Barr virus, cytomegalovirus, and Mycoplasma pneumoniae, yielded negative results.
Findings:
- The patient's condition was diagnosed as Lipschütz ulcer based on exclusion after ruling out other causes.
- The ulcers resolved completely within four weeks with symptomatic treatment, and the patient remained fever-free.
Implications:
- This case underscores the possibility of Lipschütz ulcers in very young children, challenging the typical demographic presentation.
- The diagnosis of exclusion highlights the importance of considering rare conditions even in atypical patient populations.
- The self-limited nature and lack of sexual transmission are crucial for appropriate patient counseling and management.
Abstract:
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.
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