ACUTE GENITAL ULCER (LIPSCHÜTZ)

CASE REPORT

Abstract

Acute genital ulcer, also known as Lipschütz ulcer, is an unusual, benign condition that affects women predominantly in the prepuberal and young adult phases and who have not started sexual activity. Case report: Female patient, 18 years old, virgin, with an ulcer in the left minor and major labia of the vulva. She reported an oropharyngeal condition similar to the appearance of the vulvar lesions. She had multiple ulcers, with delimited borders, necrotic background, edema and fibrin. Serological laboratory tests showed chronic reactive infection by the Epstein-Barr virus. She received treatment with prednisone, associated with sitz baths with potassium permanganate, in addition to the use of analgesics and non-hormonal anti-inflammatory drugs. Complete remission of the lesion was achieved after four weeks. Discussion: The literature shows that the etiology of acute genital ulcer is not well established and the pathophysiological mechanism is uncertain. The ulcer, usually preceded by a prodromal phase, is characterized by delimited edges, with a hardened bottom and a purulent and necrotic aspect, which can be single or multiple, causing local burning and pain. The diagnosis is clinical and exclusionary, laboratory tests assist in the differential diagnosis and biopsy has little diagnostic utility. Treatment is based on clinical support for symptom relief and corticosteroid therapy is controversial. We believe that the potassium permanganate sitz bath is a good choice as an adjunct in the treatment of ulcers, as it has antiseptic, bactericidal and astringent properties. Further studies are needed to guide the correct and rapid diagnosis and treatment of these patients.