• Pediatric emergency care · Feb 2021

    Vulvar Ulcers in Children: Dramatic But Self-Limited.

    • Maria Charamanta, Alexandra Soldatou, and Lina Michala.
    • From the 1st Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens, Alexandra Hospital.
    • Pediatr Emerg Care. 2021 Feb 1; 37 (2): 707270-72.

    ObjectiveWe aimed to describe our experience in diagnosing and managing Lipschutz ulcers in children.MethodsThis was a retrospective data review in a tertiary referral clinic for pediatric and adolescent gynecology. We identified patients referred with a vulval ulcer and recorded relating symptoms, presentation, and resolution.ResultsWe identified 7 nonsexually active girls with vulvar ulcers presenting within the course of an upper respiratory infection, including fever and cough. Average age was 12.25 years (range, 11-14.5 years). All patients presented with at least one large painful ulcer within the inner surface of the labium minor, of up to 2 cm in diameter.Initial presentation was of a bullous lesion that was then ulcerated, covered by a black gangrenous scab. Over the course of the week, the scab fell leaving a white-based ulcer that gradually healed. All children complained of dysuria stemming from contact irritation with urine. The ulcer gradually disappeared, leaving no mark within 10 days of initial presentation.Two of 7 patients presented with 3 similar recurrences after flu-like symptoms.None of the patients qualified for diagnosis of Behcet disease.ConclusionsLipschutz ulcers are painful genital lesions causing anxiety to the girl and her family. Pediatricians and gynecologists should be aware of the condition, diagnose it where appropriate, avoid unnecessary medication, and reassure the patient that it is self-limited.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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