Archives of Gynecology and Obstetrics

, Volume 298, Issue 5, pp 927–931 | Cite as

Acute genital ulcers: keep Lipschütz ulcer in mind

  • Anucha Andrade Schindler LealEmail author
  • Carla Azevedo Piccinato
  • Ana Paula Avritscher Beck
  • Mariano Tamura Vieira Gomes
  • Sergio Podgaec
General Gynecology



Lipschütz ulcers (LU) were first described as rare vulvar ulcerations that affect adolescents without previous history of sexual contact. However, more LU patients have been identified in acute genital ulcers (AGU) services in Europe.


To review cases of AGU and analyze the occurrence of LU in the Ob/Gyn Emergency Department of a Brazilian private hospital, using the currently used diagnostic criteria.


All female patients who sought our service with AGU complaints from January 2009 to July 2015 were selected and had their medical records reviewed, considering the clinical data and some diagnostic criteria, that included: < 20 years old, first AGU episode, sudden onset, absence of sexual contact 3 months before onset and the absence of immunodeficiency.


273 patients eligible for analysis were identified according to the criteria and 12 (4.39%) of them were identified with the possible diagnosis of LU. By applying less restrictive criteria that allowed the inclusion of patients of any age and sexual status, 98 were identified (35.89%).


Despite being described as a rare pathology, ours and previous results indicate a considerable number of AGU cases, suggesting that LU should be better known and considered for differential diagnosis.


Acute genital ulcer Acute vulvar ulcer Lipschütz ulcer Ulcus vulvae acutum Vulvar disease 


Author contributions

AASL: Project development, Data collection, Data analysis, Manuscript writing. CAP: Project development, Management, Data analysis, Manuscript editing. APAB: Project development, Management, Data analysis, Manuscript editing. MTVG: Management, Manuscript editing. SP: Management, Manuscript editing.


This study did not need funding.

Compliance with ethical standards

Conflict of interest

The author Anucha Andrade Schindler Leal declares that she has no conflict of interest. Author Ana Paula Avritscher Beck declares that she has no conflict of interest. The author Carla de Azevedo Piccinato declares that she has no conflict of interest. The author Mariano Tamura Vieira Gomes declares that he has no conflict of interest. The author Sergio Podgaec declares that he has no conflict of interest.

Ethical statement

Procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

This descriptive and retrospective study was conducted in the Hospital Israelita Albert Einstein (HIAE), Sao Paulo/Brazil, upon approval of the Institution Ethical Committee. For research confidentiality, data analysis was performed anonymously; for that purpose, an identification number was assigned for each patient and the patients’ names were not mentioned during analysis. The requirement for an Informed Consent Form was waived by the Committee.


  1. 1.
    Barrett MM, Sangüeza M, Werner B, Kutzner H, Carlson JA (2015) Lymphocytic arteritis in Epstein–Barr virus vulvar ulceration (Lipschütz disease): a report of 7 cases. Am J Dermatopathol 37(9):691–698. CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Huppert JS (2010) Lipschutz ulcers: evaluation and management of acute genital ulcers in women. Dermatol Ther 23:533–540. CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Bounniyt H, Mael-Ainin M, Bouhallab J, Hassam B (2015) Lipschütz ulcer: a rare case of genital ulcers. Presse Med 44(1):117–118. CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Raffas W, Hassam B (2013) Lipschütz ulcer: a rare and underdiagnosed cause of genital ulcer. Pan Afr Med J 15:43. CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Burguete Archel E, Ruiz Goikoetxea M, Recari Elizalde E, Beristain Rementería X, Gómez Gómez L, Iceta Lizarraga A (2013) Lipschütz ulcer in a 17-month-old girl: a rare manifestation of Epstein–Barr primoinfection. Eur J Pediatr 172(8):1121–1123. CrossRefPubMedPubMedCentralGoogle Scholar
  6. 6.
    Truchuelo MT, Vano-Galván S, Alcántara J, Pérez B, Jaén P (2012) Lipschütz ulcers in twin sisters. Pediatr Dermatol 29(3):370–372. CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Chanal J, Carlotti A, Laude H, Wallet-Faber N, Avril MF, Dupin N (2010) Lipschütz genital ulceration associated with mumps. Dermatology 221(4):292–295. CrossRefPubMedPubMedCentralGoogle Scholar
  8. 8.
    Pelletier F, Aubin F, Puzenat E, Deprez P, Blanc D, Estavoyer JM, Humbert P (2003) Lipschütz genital ulceration: a rare manifestation of paratyphoid fever. Eur J Dermatol 13(3):297–298PubMedPubMedCentralGoogle Scholar
  9. 9.
    Swaminathan S, Kelley P, Ahern M, Gordon D (2007) Acute cytomegalovirus infection presenting with severe vulvar swelling. Int J Gynaecol Obstet 99:133–134. CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Brinca A, Canelas MM, Carvalho MJ, Vieira R, Figueiredo A (2012) Lipschütz ulcer (ulcus vulvae acutum): a rare cause of genital lesion. An Bras Dermatol 87(4):622–624CrossRefPubMedCentralGoogle Scholar
  11. 11.
    Hernández-Núñez A, Córdoba S, Romero-Maté A, Miñano R, Sanz T, Borbujo J (2008) Lipschütz [corrected] ulcers—four cases. Pediatr Dermatol 25(3):364–367. CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Lipschütz B (1913) Über eine eigenartige geschwürsform des weiblichen genitales (ulcus vulvae acutum). Arch Dermatol Syphilol 114:363–395CrossRefGoogle Scholar
  13. 13.
    Farhi D, Wendling J, Molinari E, Raynal J, Carcelain G, Morand P, Avril MF, Francès C, Rozenberg F, Pelisse M, Dupin N (2009) Non-sexually related acute genital ulcers in 13 pubertal girls: a clinical and microbiological study. Arch Dermatol 145:38–45. CrossRefPubMedPubMedCentralGoogle Scholar
  14. 14.
    Vieira-Baptista P, Lima-Silva J, Beires J, Martinez-de-Oliveira J (2016) Lipschütz ulcers: should we rethink this? An analysis of 33 cases. Eur J Obstet Gynecol Reprod Biol 198:149–152. CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    García JG, Pavón BM, Martín LM, Martínez BF, Norniella CM, Caro FÁ (2016) Lipschütz ulcer: a cause of misdiagnosis when suspecting child abuse. Am J Emerg Med 34(7):13261–13262. CrossRefGoogle Scholar
  16. 16.
    Haidari G, MacMahon E, Tong CY, White JA (2015) Genital ulcers: it is not always simplex. Int J STD AIDS 26(1):72–73. CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Hospital Israelita Albert EinsteinSão PauloBrazil

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