Introduction: Lipschütz ulcers are a rare immune-mediated reaction that commonly occurs in premenarchal females, usually associated with a recent viral illness.1
The treatment for Lipschütz ulcers consists of pain relief, topical steroids, and, in severe cases, a course of systemic steroids.1 A thorough history and exam, as well as an appropriate workup to rule out other causes of vaginal ulceration, should be completed.2
Case Report: A premenarchal, 12-year-old female presented to the emergency department (ED) with her mother due to significant vulvar pain. Two days prior, the patient had a gastrointestinal illness associated with vomiting, diarrhea, and fever. On exam, she had significant swelling of the labia minor, discoloration with a necrotic appearance of the introitus, and brown vaginal discharge.The patient denied sexual intercourse, concern for retained vaginal foreign body, or vaginal trauma. Gynecology suggested the diagnosis of a rare post-viral immune-mediated reaction causing acute genital ulcerations, also known as Lipschütz ulcers. The patient’s treatment regimen included topical and systemic steroids, enteral opioid pain medication, and topical lidocaine. Her symptoms had resolved at her two-month follow-up visit.
Conclusion: In summary, this case report discusses a previously healthy 12-year-old premenarchal female who presented to the ED due to vulvar swelling, pain, and vaginal discharge in the setting of a recent viral gastrointestinal illness. The patient was seen in the ED by gynecology and diagnosed with Lipschütz ulcers. Lipschütz ulcers are an uncommon condition causing acute genital ulcers.
