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Sadoghi, B; Stary, G; Wolf, P; Komericki, P.
Ulcus vulvae acutum Lipschütz (UVAL): a systematic literature review and a diagnostic and therapeutic algorithm.
J Eur Acad Dermatol Venereol. 2019; [OPEN ACCESS]
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Autor/innen der Med Uni Graz:
Komericki Peter
Sadoghi Birgit
Wolf Peter
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Abstract:
The case report literature on ulcus vulvae acutum Lipschütz (UVAL) is scant, and specific guidelines on its diagnosis and treatment are lacking. Our study aim was to perform a systematic literature review of UVAL in order to formulate a diagnostic and therapeutic algorithm. Using the PRISMA criteria, we searched PubMed and MEDLINE for the terms "ulcus vulvae acutum", "Lipschütz ulcer", and "acute genital ulcer AND vulva". We extracted relevant data on "type of article", "patients' age", "amount and localization of ulcers", "presence of flu-like symptoms", "prior sexual contacts", "diagnostic work up" (including histology, blood count, and serology such as Epstein-Barr virus testing), and "treatment/ outcome". Data were meta-analysed and comparative analyses were discussed in order to create a diagnostic algorithm and recommendations for management. Twenty-one publications reporting a total of 60 cases of UVAL were included for analysis. On this basis, we formulated a diagnostic and therapeutic algorithm defined by 2 major and 4 minor criteria. The major criteria were (1) acute onset of one or more painful ulcerous lesions in the vulvar region and (2) exclusion of infectious and non-infectious causes for the ulcer. The minor criteria were (1) localization of ulcer at vestibule or labia minora, (2) no sexual intercourse ever (i.e., patient was a virgin) or within the last 3 months, (3) flu-like symptoms, and/or (4) systemic infection within 2-4 weeks prior to onset of vulvar ulcer. Use of a symptom-based treatment algorithm based on our proposed major and minor criteria will improve the diagnosis and management of UVAL. © 2019 European Academy of Dermatology and Venereology.

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