๐ ็ธฝ็ฎ้ ๏ฝ ๐ ่ฑๆๅๆ๏ผๆฌ็ฏ๏ผ ๏ฝ ๐ ๅฎๆด็ฟป่ญฏ ๏ฝ โญ ็ฒพ่ฏ็ญ่จ
Lipschutz ulcer
Lipschutz ulcer
Clinical features This condition is seen in teenage girls who present with vulval ulceration of sudden onset. Lesions may be solitary or multiple.1 The initial lesion is a tender purpuric or hemorrhagic papule that rapidly enlarges and ulcerates. The ulcers are deep and painful, and have sharply delineated erythematous margins. There may be an accompanying fever, malaise, and cervical lymphadenopathy. A similar condition does not occur in males.
Pathogenesis and histologic features The condition is a toxic reaction to a systemic infection. The most commonly associated infection is EBV infection (infectious mononucleosis).1 Other associated infections have included typhoid and paratyphoid, mycoplasma, mumps, and cytomegalovirus.2โ5 The microscopic appearance shows non-specific superficial ulceration with granulation tissue, fibrin deposition, and a mixed inflammatory cell infiltrate. It is suggested that a localized lymphocytic arteritis is a common feature6 The presence of the EBV can be demonstrated by in situ hybridization.
Fig. 12.70 Pili incarnati: lesion from the groin showing and inflamed follicular lesion. From Bunker C. Male Genital Skin Disease. Saunders Ltd./Elsevier 2004.