{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T07:29:42Z","timestamp":1793345382773,"version":"4.5.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T00:00:00Z","timestamp":1705363200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Reprod. Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Ulcus Vulvae Acutum Lipsch\u00fctz (UVAL) is a largely unknown disease with a broad and complex differential diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To provide a description of the main characteristics of UVAL, determine the most appropriate diagnostic process and describe the current therapeutic approach.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We designed a retrospective, descriptive cohort study using the gynecological-ER database of our institution. <jats:italic>Inclusion criteria:<\/jats:italic> female patients aged between 10 and 20 years old with suspicion of a UVAL diagnosis at CHUV's gynecological ER. <jats:italic>Data extraction<\/jats:italic>: epidemiological characteristics, clinical presentation, laboratory tests, established diagnostics, treatment, and ulcer outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>15 patients were included for the analysis; average age: 15 years old; 60% of patients were virgo at the time of ulcer onset; all patients had at least one flu-like symptom concomitant with the vulvar lesion; the most-performed serology was for EBV and acute disease was present in only one patient; for diagnostic purposes two biopsies were performed with both inconclusive histopathology analysis; the main prescribed treatments were: oral NSAIDs, Paracetamol, and Lidocaine gel; 93% of cases presented signs of regression; the average follow-up time was 10 days. <jats:italic>The diagnostic algorithm of Sadoghi et al:<\/jats:italic> 10 out of 15 cases were retrospectively diagnosed with UVAL by the algorithm; half were diagnosed with UVAL, and the other half received a diagnosis of \u201culcers of unknown origin\u201d at the time of the gynecological ER visit.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We highly recommend the diagnostic and therapeutic algorithms developed by Sadoghi et al. as valuable tools to guide clinical reasoning and, consequently, improve acute vulvar ulcers management.<\/jats:p><\/jats:sec>","DOI":"10.3389\/frph.2023.1333620","type":"journal-article","created":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T04:23:57Z","timestamp":1705379037000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Ulcus Vulvae Acutum Lipsch\u00fctz\u2014UVAL: case series at a Swiss university hospital emergency room"],"prefix":"10.3389","volume":"5","author":[{"given":"Vittoria","family":"Guareschi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrice","family":"Mathevet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martine","family":"Jacot-Guillarmod","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,16]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"363","DOI":"10.1007\/BF01973166","article-title":"\u00dcber eine eigenartige Geschw\u00fcrsform des weiblichen Genitales (Ulcus vulvae acutum)","volume":"114","author":"Lipsch\u00fctz","year":"1913","journal-title":"Arch Dermatol Syph"},{"key":"B2","doi-asserted-by":"publisher","first-page":"528","DOI":"10.1016\/j.jgyn.2009.08.005","article-title":"Acute ulcer of Lipsch\u00fctz\u2019s vulva","volume":"38","author":"Kluger","year":"2009","journal-title":"J Gynecol Obstet Biol Reprod"},{"key":"B3","doi-asserted-by":"publisher","first-page":"44","DOI":"10.1016\/j.jaad.2009.08.038","article-title":"Reactive nonsexually related acute genital ulcers: review of cases evaluated at Mayo clinic","volume":"63","author":"Lehman","year":"2010","journal-title":"J Am Acad Dermatol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"1660","DOI":"10.1111\/jdv.15598","article-title":"Lipschutz genital ulcer revisited: is juvenile gangrenous vasculitis of the scrotum the male counterpart","volume":"33","author":"Chen","year":"2019","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1559","DOI":"10.1007\/s00431-020-03647-y","article-title":"Lipsch\u00fctz\u2019s acute vulvar ulcer: a systematic review","volume":"179","author":"Vismara","year":"2020","journal-title":"Eur J Pediatr"},{"key":"B6","doi-asserted-by":"publisher","first-page":"927","DOI":"10.1007\/s00404-018-4866-6","article-title":"Acute genital ulcers: keep Lipsch\u00fctz ulcer in mind","volume":"298","author":"Leal AA","year":"2018","journal-title":"Arch Gynecol Obstet"},{"key":"B7","doi-asserted-by":"publisher","first-page":"1326.e1","DOI":"10.1016\/j.ajem.2015.12.027","article-title":"Lipsch\u00fctz ulcer: a cause of misdiagnosis when suspecting child abuse","volume":"34","author":"Garc\u00eda","year":"2016","journal-title":"Am J Emerg Med"},{"key":"B8","doi-asserted-by":"publisher","first-page":"1432","DOI":"10.1111\/jdv.16161","article-title":"Ulcus vulvae acutum Lipsch\u00fctz: a systematic literature review and a diagnostic and therapeutic algorithm","volume":"34","author":"Sadoghi","year":"2020","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B9","author":"Delgado-Garcia","year":"2014"},{"key":"B10","doi-asserted-by":"publisher","first-page":"149","DOI":"10.1016\/j.ejogrb.2015.07.016","article-title":"Lipsch\u00fctz ulcers: should we rethink this? An analysis of 33 cases","volume":"198","author":"Vieira-Baptista","year":"2016","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"73","DOI":"10.33590\/emjreprohealth\/10311698","article-title":"Lipsch\u00fctz ulcers: a Literature review based on 79 cases","volume":"2","author":"Govindan","year":"2016","journal-title":"EMJ Repro Health"},{"key":"B12","doi-asserted-by":"publisher","first-page":"E73","DOI":"10.1097\/PEC.0000000000000761","article-title":"Case report: not all genital ulcers are herpetic","volume":"34","author":"Austin","year":"2018","journal-title":"Pediatr Emerg Care"},{"key":"B13","doi-asserted-by":"publisher","first-page":"195","DOI":"10.1016\/j.jpag.2006.02.006","article-title":"Vulvar ulcers in young females: a manifestation of aphthosis","volume":"19","author":"Huppert","year":"2006","journal-title":"J Pediatr Adolesc Gynecol"},{"key":"B14","first-page":"55","article-title":"Ulcer of Lipschutz, a rare and unknown cause of genital ulceration","volume":"10","author":"Moise","year":"2018","journal-title":"Facts Views Vis Obgyn"},{"key":"B15","year":""},{"key":"B16","year":"2009"},{"key":"B17","first-page":"387","article-title":"Ulcus vulvae acutum","volume":"65","author":"T\u00f6r\u00f6k","year":"2000","journal-title":"Cutis"},{"key":"B18","doi-asserted-by":"publisher","first-page":"e151","DOI":"10.4321\/S1139-76322014000500013","article-title":"Lipsch\u00fctz ulcer: gangrenous form","volume":"16","author":"Pl\u00e1cido Paias","year":"2014","journal-title":"Rev Pediatr Aten primaria"},{"key":"B19","first-page":"913","article-title":"Genital ulcerations during primary Epstein-Barr virus infection","volume":"26","author":"Nicolas","year":"2005","journal-title":"J Intern Med"},{"key":"B20","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1111\/j.1529-8019.2010.01356.x","article-title":"Lipschutz ulcers: evaluation and management of acute genital ulcers in women: Lipschutz ulcers","volume":"23","author":"Huppert","year":"2010","journal-title":"Dermatol Ther"},{"key":"B21","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1001\/archdermatol.2008.519","article-title":"Non-sexually related acute genital ulcers in 13 pubertal girls: a clinical and microbiological study","volume":"145","author":"Farhi","year":"2009","journal-title":"Arch Dermatol"},{"key":"B22","doi-asserted-by":"publisher","first-page":"517","DOI":"10.1186\/s13256-021-03087-8","article-title":"When obstetrics\u2013gynecology specialists need to call an ophthalmologist urgently: a case report","volume":"15","author":"Masmejan","year":"2021","journal-title":"J Med Case Rep"},{"key":"B23","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1080\/1744666X.2019.1705786","article-title":"Behcet\u2019s disease in Iraq: new insights into the clinical and epidemiologic features in Middle-Euphrates region","volume":"16","author":"Alkazzaz","year":"2020","journal-title":"Expert Rev Clin Immunol"},{"key":"B24","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1111\/j.1525-1470.2007.00597.x","article-title":"Lipsch\u00fctz acute vulval ulcers associated with primary cytomegalovirus infection","volume":"25","author":"Mart\u00edn","year":"2008","journal-title":"Pediatr Dermatol"},{"key":"B25","doi-asserted-by":"publisher","first-page":"278","DOI":"10.1016\/S1085-5629(97)80017-X","article-title":"Recurrent aphthous stomatitis: clinical characteristics and associated systemic disorders","volume":"16","author":"Rogers","year":"1997","journal-title":"Semin Cutan Med Surg"}],"container-title":["Frontiers in Reproductive Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2023.1333620\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,16]],"date-time":"2024-01-16T04:24:00Z","timestamp":1705379040000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/frph.2023.1333620\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,16]]},"references-count":25,"alternative-id":["10.3389\/frph.2023.1333620"],"URL":"https:\/\/doi.org\/10.3389\/frph.2023.1333620","relation":{},"ISSN":["2673-3153"],"issn-type":[{"value":"2673-3153","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,16]]},"article-number":"1333620"}}