2016, Number 12
Ginecol Obstet Mex 2016; 84 (12)
Peláez-Marín G, Tato-Varela S, Rodríguez-Gómez RM, Gaitán-Quintero N
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ABSTRACTClinical case: We describe a case of 19-year-old women, who came to the emergency services with fever of 38.5 °C and severe pain in the external genitals. Physical examination of the vulva showed edema, with an ulcerated and painless to palpation in the lower lip (diameter of 4 cm), purplish edges indurated and exudative material in the central region. Laboratory studies showed mild leukocytosis (15 x 103/µL), neutrophil 85.7% and C-reactive protein 156 mg/dL. Empirical treatment was initiated: benzathine penicillin G and doxycycline, steroids and washed with sodium chloride solution. Diagnosis of acute vulvar ulcer (ulcer Lipschütz´s) was established jointly with the Department of Dermatology. Application fusidic acid was indicated. We observed decreased of C reactive protein concentration and leukocytosis. The systemic symptoms and ulcers disappeared totally seven days after, and laboratory tests were normal. Lipschütz´s ulcer (acute genital ulcers not related to sexually transmitted diseases) is a entity remains unrecognized by health care providers, requiring a conservative management, with special importance of pain control.