Acute genital ulcers: keep Lipschütz ulcer in mind
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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.
KeywordsAcute genital ulcer Acute vulvar ulcer Lipschütz ulcer Ulcus vulvae acutum Vulvar disease
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.
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.
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.
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