Non-sexually transmitted genital ulcers that cause flu-like symptoms and occur rarely are called Lipschutz ulcers. While most of the time these ulcers disappear on their own within 5-6 weeks, doctors may recommend some treatments to ease the symptoms.
In other words, Lipschutz ulcers cause one or multiple ulcers on the vulva (on one or both labia minora) that can be painful. In some cases, this condition causes ulcers to appear on the labia majora, at the vaginal opening, or on the urethra.
Sometimes, this condition is called non-sexually acquired genital ulcerations or ulcus vulvae acutum. The name of this disorder comes from Benjamin Lipschutz, the doctor who first described the ulcer. Healthcare providers do not know how common this condition is, but it happens rarely.
What Are The Symptoms of Lipschutz Ulcers?
While the primary symptom of this condition is a large and painful ulcer, it may also cause other symptoms. Check some examples below:
- Fatigue (extreme tiredness)
- Swollen lymph nodes in the neck and armpits
- Sore throat or swollen tonsils
- Dysuria (painful urination)
- Cough
- Body aches
- Joint pain
- Fever
If any of the previous symptoms occur, immediately contact your healthcare professional. Otherwise, it may lead to serious complications. Typically, a Lipschutz ulcer has the following features. Examples include:
- Round and it is less than 1 centimeter in diameter
- Most of the time, it appears on the vulva (on the labia minora)
- Often has a distinct center that contains damaged or dead tissue
- Usually, the ulcer’s border is reddish-purple
- There is a clear separation between the center and border
Causes and Risk Factors
Experts do not fully understand what exactly causes Lipschutz ulcers, but they think viral and bacterial infections and Epstein-Barr virus could play a role. For instance, if your immune system is weakened and you get a viral infection, the ulcers appear in response to the infection. Check below for additional viruses or bacteria that may also contribute to these ulcers:
- Salmonella
- Group A Streptococcus
- COVID-19
- Influenza A and influenza B
- Cytomegalovirus (CMV)
- Mumps
- Mycoplasma
In addition, these ulcers are not contagious, which means they cannot spread from one person to another through physical or bodily contact.
While anyone can develop Lipschutz ulcers, doctors have identified some factors that may increase your risk. Examples include:
- Sex – Commonly, these ulcers affect women. It may also happen in men, but it is very rare.
- Age – People younger than 20 with a recent medical history of a viral or bacterial infection are at increased risk of Lipschutz ulcers.
- Autoimmune and inflammatory conditions – For example, Sjogren’s syndrome, Crohn’s disease, or Behcet’s syndrome.
- Certain medicines
- Parasitic infections
These ulcers may occur even in people who are not sexually active. It means they have not had oral, anal, or vaginal sex for more than 3 months.
What Happens if Lipschutz Ulcers Are Left Untreated?
Commonly, these ulcers do not cause any long-term health problems and heal on their own. However, some people may experience the following complications, especially if they develop a moderate to severe form. Check some examples below:
- Scarring – Sometimes, the ulcer is large or deep, which may cause a spot of discoloration.
- Emotional distress – These ulcers can cause pain and negatively affect your quality of life. Moreover, in rare cases, this condition is mistaken for a sexually transmitted infection (STI), which may also affect your self-esteem.
- Urinary retention
- Difficulty walking and sitting
- Secondary bacterial infections – An open ulcer allows bacteria to enter the body. As a result, it may lead to an infection (including local cellulitis).
- Recurrence – About 30% of people who have had Lipschutz ulcers will develop them again.
This document does not contain a full list of complications. In any case, physicians may recommend some options that will help reduce the risk or even prevent the previous complications.
Is There a Way to Prevent Lipschutz Ulcers?
Unfortunately, there is no way to prevent this condition because doctors do not know the exact cause. However, they may recommend some tips that will help maintain a healthy immune system and reduce the risk of infections. For example:
- Regularly wash your hands with soap and warm water
- Practice safe sex by using dental dams or condoms
- Wash your genital area thoroughly with mild soap and water every day
- Get quality sleep
- Manage stress and chronic health conditions (such as diabetes, hypertension, and others)
- Dietary changes – Usually, doctors recommend adding nutritious foods to your diet nutritious foods, including vegetables, fruits, and lean protein. You should also limit or avoid processed foods, desserts, and foods high in saturated fats.
Diagnosis
Commonly, this condition is diagnosed by excluding other conditions that cause similar symptoms. Anyway, doctors begin the diagnosis with a physical examination to check for irregularities linked to the disease and questions about your symptoms and medical history to get more information about your disease. Check below for other conditions that may cause symptoms similar to Lipschutz ulcers:
- HIV infection
- Genital herpes
- Syphilis
- Behcet’s disease
- Sjogren’s syndrome
Is Lipschutz Ulcer an Autoimmune Disorder?
While physicians have not categorized this condition as an autoimmune disease, it has a strong link to other autoimmune conditions.
Treatment
Not everyone who develops these ulcers needs treatment because they heal themselves within 5-6 weeks. However, if an ulcer bothers you or causes pain, physicians may recommend the following options. Examples include:
- Take sitz baths – These involve sitting in a bathtub filled with several inches of warm water.
- Avoid tight clothes
- Over-the-counter (OTC) pain relievers – These include Ibuprofen, Acetaminophen, and others.
- Topical anesthetics – In some cases, doctors may recommend prescription or OTC medicines that contain Lidocaine to numb the affected area and reduce pain.
When you develop Lipschutz ulcers due to infections, physicians may also prescribe antibiotics (to treat bacterial infections), antivirals (medicines used to treat viral infections), and anti-parasitic medications.
Frequently Asked Questions
Are Lipschutz ulcers sexually transmitted?
No. Lipschutz ulcers are not sexually transmitted infections (STIs). They are non-sexually acquired genital ulcers and cannot be spread through sexual contact or other forms of physical contact. However, because they can resemble STIs such as genital herpes, doctors usually perform tests to rule out other causes.
How long do Lipschutz ulcers usually last?
Most Lipschutz ulcers heal on their own within 2 to 6 weeks, with many resolving in approximately 5 to 6 weeks. During this time, treatment mainly focuses on relieving pain and preventing secondary infections.
Who is most likely to develop Lipschutz ulcers?
Lipschutz ulcers most commonly affect adolescent girls and young women, especially those under 20 years old who recently had a viral or bacterial infection. Although rare, the condition can also occur in adults and, very rarely, in males.
Can Lipschutz ulcers come back after they heal?
Yes. Although many people experience only one episode, recurrence is possible. Studies suggest that approximately 30% of people may develop Lipschutz ulcers again, particularly if they experience another triggering infection or have certain inflammatory or autoimmune conditions.
Are Lipschutz ulcers a sign of poor hygiene?
No. Poor hygiene does not cause Lipschutz ulcers. These ulcers are believed to result from an abnormal immune response to an infection rather than inadequate personal hygiene. Maintaining good hygiene may help prevent secondary infections but does not prevent the ulcers themselves.
When should I see a doctor for a genital ulcer?
You should seek medical attention if you develop a painful genital ulcer, especially if it is accompanied by fever, swollen lymph nodes, difficulty urinating, severe pain, or persistent symptoms. A healthcare provider can rule out sexually transmitted infections and other serious conditions before confirming a diagnosis of Lipschutz ulcers.
Can Lipschutz ulcers affect urination?
Yes. Some people experience painful urination (dysuria), while severe ulcers may make urination difficult or even lead to temporary urinary retention. If you cannot urinate normally, seek immediate medical care.
Do Lipschutz ulcers leave scars?
Most ulcers heal without permanent scarring. However, larger or deeper ulcers may occasionally leave mild discoloration or small scars after they resolve, particularly if a secondary bacterial infection develops.
Can stress trigger Lipschutz ulcers?
Stress alone is not considered a direct cause of Lipschutz ulcers. However, prolonged stress may weaken the immune system, potentially making infections more likely, which could indirectly contribute to the development of these ulcers in susceptible individuals.
Is hospitalization ever needed for Lipschutz ulcers?
Hospitalization is uncommon but may be necessary in severe cases. People with intense pain, dehydration, inability to urinate, extensive ulcers, or complications such as secondary bacterial infections may require hospital-based treatment, pain management, or intravenous medications. If you have additional questions, ask your healthcare provider.
