Acute genitale ulcera en Lipschütz-ulcus: differentiaaldiagnose en behandeling

Abstract

Acute genital ulcerations and Lipschütz ulcus: differential diagnosis and treatment Lipschütz ulcus is a rare cause of acute genital ulceration. It mostly occurs in female patients of adolescent age and even in young children. In contrast to some of the more frequent causes of genital ulcerations, it is non-sexually related. It presumably occurs as a reaction to a non-genital infection and may thus also occur in virgins. It is mostly associated with an Epstein-Barr virus infection, but other pathogens such as influenza or the coronavirus can also cause this kind of reaction. When a patient presents with acute genital ulcerations, Lipschütz ulcus should be considered in the differential diagnosis. It is a diagnosis by exclusion since no specific diagnostic test is available. In order to distinguish between the different causes of genital ulcerations, it is important to perform a thorough sexual anamnesis, to be alert for possible signs of sexual abuse, to ask the patient about recent flu-like symptoms and to screen for the presence of extragenital lesions. It is a self-limiting condition. The lesions heal spontaneously after a couple of weeks. The treatment is supportive, consisting of analgesia and the prevention of secondary complications such as a bacterial superinfection, urinary retention due to dysuria or scarring. In severe cases with extensive lesions and/or insufficient pain control by other means, a treatment with corticosteroids may be considered, preferably topically.