Skip to main content
Top
Published in: European Journal of Pediatrics 8/2013

01-08-2013 | Short Communication

Lipschütz ulcer in a 17-month-old girl: a rare manifestation of Epstein–Barr primoinfection

Authors: Edurne Burguete Archel, Maite Ruiz Goikoetxea, Eva Recari Elizalde, Xabier Beristain Rementería, Lourdes Gómez Gómez, Ainhoa Iceta Lizarraga

Published in: European Journal of Pediatrics | Issue 8/2013

Login to get access

Abstract

Lipschütz ulcer is an uncommon entity that is clinically characterised by a flu-like syndrome accompanied by an acute painful necrotic vulvar ulcer. It typically occurs in young women with no sexual contact history, and it is very rare among children. The aetiology is unknown, although recently several reports have related Epstein–Barr virus primary infection with this entity. We report a 17-month-old girl with fever and an acute genital ulcer. All the complementary tests for the most frequent causes of vulvar ulcers yielded negative results, whereas viral serology and polymerase chain reaction technique confirmed the presence of an acute Epstein–Barr virus infection. When main causes of genital ulcer have been excluded, and there is no history of sexual contact, Lipschütz ulcer should be included in the differential diagnosis. Detection of Epstein–Barr virus genome by polymerase chain reaction can lead to an earlier diagnosis.
Footnotes
1
No bacteria were found in blood, skin tissue, stools or urine cultures. Serological tests for Chlamydia trachomatis, Chlamydia pneumonia, Treponema pallidum, human immunodeficiency viruses (1 and 2), herpes viruses (1 and 2), Cytomegalovirus and hepatitis C virus were also negative, as was Paul–Bunnel test. Furthermore, Mantoux skin test result was 0 mm, and C. trachomatis PCR of genital sore was normal.
 
2
Hygiene measures consist in maintaining clean and dry the genital area, avoiding the use of the nappy whenever possible and changing the nappy frequently.
 
Literature
1.
go back to reference Bargman H (1983) Penile ulcer and infectious mononucleosis. Can Med Assoc J 129:1176PubMed Bargman H (1983) Penile ulcer and infectious mononucleosis. Can Med Assoc J 129:1176PubMed
2.
go back to reference Barnes CJ, Alio AB, Cunningham BB, Friedlander SF (2007) Epstein–Barr virus-associated genital ulcers: an under-recognized disorder. Pediatr Dermatol 24:130–134PubMedCrossRef Barnes CJ, Alio AB, Cunningham BB, Friedlander SF (2007) Epstein–Barr virus-associated genital ulcers: an under-recognized disorder. Pediatr Dermatol 24:130–134PubMedCrossRef
3.
go back to reference Farhi D, Wendling J, Molinari E, Raynal J, Carcelain G, Morand P, Avril MF, Frances 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 145:38–45PubMedCrossRef Farhi D, Wendling J, Molinari E, Raynal J, Carcelain G, Morand P, Avril MF, Frances 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 145:38–45PubMedCrossRef
4.
go back to reference Lawee D, Shafir MS (1983) Solitary penile ulcer associated with infections mononucleosis. Can Med Assoc J 129:146–147PubMed Lawee D, Shafir MS (1983) Solitary penile ulcer associated with infections mononucleosis. Can Med Assoc J 129:146–147PubMed
5.
go back to reference Lipschütz B (1912) Über eine eigenartige Geschwürsform des weiblichen Genitales (Ulcus vulvae acutum). Arch Dermatol Res 114:363–396CrossRef Lipschütz B (1912) Über eine eigenartige Geschwürsform des weiblichen Genitales (Ulcus vulvae acutum). Arch Dermatol Res 114:363–396CrossRef
6.
go back to reference Martin JM, Godoy R, Calduch L, Villalon G, Jorda E (2008) Lipschütz acute vulval ulcers associated with primary cytomegalovirus infection. Pediatr Dermatol 25:113–115PubMedCrossRef Martin JM, Godoy R, Calduch L, Villalon G, Jorda E (2008) Lipschütz acute vulval ulcers associated with primary cytomegalovirus infection. Pediatr Dermatol 25:113–115PubMedCrossRef
7.
go back to reference Pariente M, Bartolome J, Lorente S, Crespo MD (2007) Age distribution of serological profiles of Epstein–Barr virus infection: review of results from a diagnostic laboratory. Enferm Infecc Microbiol Clin 25:108–110PubMedCrossRef Pariente M, Bartolome J, Lorente S, Crespo MD (2007) Age distribution of serological profiles of Epstein–Barr virus infection: review of results from a diagnostic laboratory. Enferm Infecc Microbiol Clin 25:108–110PubMedCrossRef
8.
go back to reference 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 13:297–298PubMed 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 13:297–298PubMed
9.
go back to reference Rosman IS, Berk DR, Bayliss SJ, White AJ, Merritt DF (2012) Acute genital ulcers in nonsexually active young girls: case series, review of the literature, and evaluation and management recommendations. Pediatr Dermatol 29:147–153PubMedCrossRef Rosman IS, Berk DR, Bayliss SJ, White AJ, Merritt DF (2012) Acute genital ulcers in nonsexually active young girls: case series, review of the literature, and evaluation and management recommendations. Pediatr Dermatol 29:147–153PubMedCrossRef
10.
go back to reference Schuster V, Kreth HW (1992) Epstein–Barr virus infection and associated diseases in children. II. Diagnostic and therapeutic strategies. Eur J Pediatr 151:794–798PubMedCrossRef Schuster V, Kreth HW (1992) Epstein–Barr virus infection and associated diseases in children. II. Diagnostic and therapeutic strategies. Eur J Pediatr 151:794–798PubMedCrossRef
11.
go back to reference Taylor S, Drake SM, Dedicoat M, Wood MJ (1998) Genital ulcers associated with acute Epstein–Barr virus infection. Sex Transm Infect 74:296–297PubMedCrossRef Taylor S, Drake SM, Dedicoat M, Wood MJ (1998) Genital ulcers associated with acute Epstein–Barr virus infection. Sex Transm Infect 74:296–297PubMedCrossRef
Metadata
Title
Lipschütz ulcer in a 17-month-old girl: a rare manifestation of Epstein–Barr primoinfection
Authors
Edurne Burguete Archel
Maite Ruiz Goikoetxea
Eva Recari Elizalde
Xabier Beristain Rementería
Lourdes Gómez Gómez
Ainhoa Iceta Lizarraga
Publication date
01-08-2013
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Pediatrics / Issue 8/2013
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI
https://doi.org/10.1007/s00431-013-2013-8

Other articles of this Issue 8/2013

European Journal of Pediatrics 8/2013 Go to the issue