Lipschütz Ulcer: An Acute Noninfectious Genital Ulcer to Bear in Mind in Adult Women

array:25 ["pii" => "S1578219020302067" "issn" => "15782190" "doi" => "10.1016/j.adengl.2018.12.018" "estado" => "S300" "fechaPublicacion" => "2020-09-01" "aid" => "2324" "copyright" => "AEDV" "copyrightAnyo" => "2020" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2020;111:624-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:20 [ "pii" => "S0001731020300806" "issn" => "00017310" "doi" => "10.1016/j.ad.2018.12.011" "estado" => "S300" "fechaPublicacion" => "2020-09-01" "aid" => "2324" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2020;111:624-6" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "es" => array:11 [ "idiomaDefecto" => true "cabecera" => "CARTA CIENTÍFICO-CLÍNICA" "titulo" => "Úlcera de Lipschütz. Una úlcera genital aguda no infecciosa para tener en cuenta en mujeres adultas" "tienePdf" => "es" "tieneTextoCompleto" => "es" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "624" "paginaFinal" => "626" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Lipschütz ulcer: an acute noninfectious genital ulcer to bear in mind in adult women" ] ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 528 "Ancho" => 805 "Tamanyo" => 140511 ] ] "descripcion" => array:1 [ "es" => "Edema de labios mayores y múltiples úlceras redondeadas con base de fibrina y halo grisáceo, distribuidas simétricamente en los labios mayores. Se puede observar la típica imagen de distribución «en beso» (kissing ulcers)." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "D. Morgado-Carrasco, X. Bosch-Amate, X. Fustà-Novell, P. Giavedoni" "autores" => array:4 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Morgado-Carrasco" ] 1 => array:2 [ "nombre" => "X." "apellidos" => "Bosch-Amate" ] 2 => array:2 [ "nombre" => "X." "apellidos" => "Fustà-Novell" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Giavedoni" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S1578219020302067" "doi" => "10.1016/j.adengl.2018.12.018" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020302067?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731020300806?idApp=UINPBA000044" "url" => "/00017310/0000011100000007/v1_202009110631/S0001731020300806/v1_202009110631/es/main.assets" ] ] "itemSiguiente" => array:20 [ "pii" => "S1578219020301979" "issn" => "15782190" "doi" => "10.1016/j.adengl.2020.06.002" "estado" => "S300" "fechaPublicacion" => "2020-09-01" "aid" => "2397" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "cor" "cita" => "Actas Dermosifiliogr. 2020;111:627" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:10 [ "idiomaDefecto" => true "cabecera" => "Letter to the Editor" "titulo" => "Chilblain and Acral Purpuric Lesions in COVID-19" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "627" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Chilblain y lesiones purpúricas acrales en COVID-19" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "V. Wiwanitkit" "autores" => array:1 [ 0 => array:2 [ "nombre" => "V." "apellidos" => "Wiwanitkit" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731020301940" "doi" => "10.1016/j.ad.2020.06.002" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731020301940?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020301979?idApp=UINPBA000044" "url" => "/15782190/0000011100000007/v1_202009190930/S1578219020301979/v1_202009190930/en/main.assets" ] "itemAnterior" => array:20 [ "pii" => "S1578219020302092" "issn" => "15782190" "doi" => "10.1016/j.adengl.2019.01.022" "estado" => "S300" "fechaPublicacion" => "2020-09-01" "aid" => "2375" "copyright" => "AEDV" "documento" => "simple-article" "crossmark" => 1 "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/" "subdocumento" => "crp" "cita" => "Actas Dermosifiliogr. 2020;111:623-4" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "en" => array:11 [ "idiomaDefecto" => true "cabecera" => "Case and Research Letters" "titulo" => "Prevalence of Syphilis in Children Adopted From Russia" "tienePdf" => "en" "tieneTextoCompleto" => "en" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "623" "paginaFinal" => "624" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Prevalencia de sífilis en niños adoptados de Rusia" ] ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1030 "Ancho" => 2092 "Tamanyo" => 198991 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Incidence of syphilis in Russia (1995–2015). Source: Federal Statistics Service of the Russian Federation: Available at: https://www.gks.ru." ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "G. Oliván-Gonzalvo" "autores" => array:1 [ 0 => array:2 [ "nombre" => "G." "apellidos" => "Oliván-Gonzalvo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0001731020301721" "doi" => "10.1016/j.ad.2019.01.019" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731020301721?idApp=UINPBA000044" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020302092?idApp=UINPBA000044" "url" => "/15782190/0000011100000007/v1_202009190930/S1578219020302092/v1_202009190930/en/main.assets" ] "en" => array:16 [ "idiomaDefecto" => true "cabecera" => "Case and Research Letters" "titulo" => "Lipschütz Ulcer: An Acute Noninfectious Genital Ulcer to Bear in Mind in Adult Women" "tieneTextoCompleto" => true "saludo" => "To the Editor" "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "624" "paginaFinal" => "626" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "D. Morgado-Carrasco, X. Bosch-Amate, X. Fustà-Novell, P. Giavedoni" "autores" => array:4 [ 0 => array:4 [ "nombre" => "D." "apellidos" => "Morgado-Carrasco" "email" => array:1 [ 0 => "morgado@clinic.cat" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "X." "apellidos" => "Bosch-Amate" ] 2 => array:2 [ "nombre" => "X." "apellidos" => "Fustà-Novell" ] 3 => array:2 [ "nombre" => "P." "apellidos" => "Giavedoni" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Úlcera de Lipschütz. Una úlcera genital aguda no infecciosa para tener en cuenta en mujeres adultas" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 528 "Ancho" => 805 "Tamanyo" => 140511 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Lipschütz ulcer. Edema of the labia majora and multiple rounded ulcers with a fibrin base and a grayish halo distributed symmetrically on the labia majora. Note the typical symmetrical distribution (kissing ulcers)." ] ] ] "textoCompleto" => "Genital ulcer is a common presenting complaint in clinical practice and may cause considerable anxiety for patients and their families.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> Its etiology is diverse and includes infection, inflammation, drugs, injury, and tumors, and diagnosis may prove challenging.<a class="elsevierStyleCrossRef" href="#bib0010">2</a> Lipschütz ulcer is an acute noninfectious genital ulcer that has traditionally been reported in girls who have not yet started having sexual relations,<a class="elsevierStyleCrossRef" href="#bib0015">3</a> although it may be a frequent cause of genital ulcer in sexually active adult women.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> We report the case of a young woman with Lipschütz ulcer.The patient was a 21-year-old woman with no history of disease and an active sex life who came to the emergency department with a 1-week history of very painful genital ulcers. She also reported odynophagia and fever during the previous 3 days. She denied having had sexual relations during the previous 2 months or having taken medication. Physical examination revealed fever (axillary temperature, 37.5 °C), painful cervical lymph nodes, and pharyngeal erythema. We observed marked edema of the labia majora and multiple round ulcers with a fibrin base and grayish halo distributed symmetrically on both sides of the vulva (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Cultures taken from the pharynx and the genital ulcers and serology for Epstein-Barr virus (EBV), including heterophile antibody agglutination testing and IgM and IgG testing were negative. Negative results were also recorded in serology testing for cytomegalovirus, Mycoplasma pneumoniae, syphilis, and HIV, as well as in the polymerase chain reaction (PCR) assay of the sample of the ulcer for herpesvirus types 1 and 2, Treponema pallidum, venereal lymphogranuloma, Chlamydia trachomatis (serotypes D-K), and Haemophilus ducreyi. PCR was not performed for influenza virus or other respiratory viruses. The patient was treated with ibuprofen 400  mg every 8 hours for 4 days, eau de Goulard dressings, and methylprednisolone 1% cream for 10 days. The patient’s condition progressed favorably with no complications. Her pain was relieved, and the ulcers healed in the following weeks.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Lipschütz ulcer is a disease of unknown origin characterized by acute painful and necrotic ulcers, which have a classic symmetrical “kissing” pattern. It is sometimes preceded by flu symptoms or mononucleosis-type symptoms and is common in young women and girls who have not yet started having sexual relations.<a class="elsevierStyleCrossRefs" href="#bib0015">3,4</a> Cases in children aged under 2 years are exceptional.<a class="elsevierStyleCrossRef" href="#bib0025">5</a> As there are no clear diagnostic criteria, Lipschütz ulcer is considered a diagnosis of exclusion; sexually transmitted infections must be ruled out as the main differential diagnosis (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).<a class="elsevierStyleCrossRef" href="#bib0005">1</a> It is generally not necessary to perform a biopsy of the mucous membrane.<a class="elsevierStyleCrossRef" href="#bib0005">1</a> Etiology and pathogenesis seem to involve a hypersensitivity reaction to a virus or bacteria such as EBV, Mycoplasma pneumoniae, cytomegalovirus, influenza virus, and Salmonella. Consequently, we observe immune complex deposition, complement activation, small vessel thrombosis, and tissue necrosis.<a class="elsevierStyleCrossRefs" href="#bib0005">1,5,6</a><elsevierMultimedia ident="tbl0005"></elsevierMultimedia>Although Lipschütz ulcer has been associated with children, a recent publication that analyzed a series of 110 women with genital ulcers found that 30% had been diagnosed with Lipschütz ulcer at a mean age of 29 years (10–79 years) and that more than 80% had started having sexual relations. No patients had symmetrical (kissing) ulcers. The most frequent finding was multiple ulcers in the vulvar vestibule, although clinical expression was markedly polymorphic. Up to 30% had had a previous episode, and an associated microorganism, such as cytomegalovirus, EBV, Mycoplasma pneumoniae, or parvovirus B19 was detected in 27%.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>Lipschütz ulcer generally resolves spontaneously in 2 to 3 weeks without scarring. Management is based on support measures and control of pain. The measures used include sitz bath (warm water), poultices/dressings, local cleansing, oral analgesics (nonsteroidal anti-inflammatory agents or paracetamol), and topical anesthetics such as lidocaine 2%. In moderate to severe cases, we can prescribe high-potency topical corticosteroids, reserving systemic corticosteroids for cases with multiple necrotic lesions. Oral antibiotics are only indicated in the case of superinfection of the ulcers or accompanying cellulitis.<a class="elsevierStyleCrossRef" href="#bib0030">6</a> Lipschütz ulcer can recur in up to one-third of patients. In recurrent cases, it is necessary to rule out Behçet disease.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>Lipschütz ulcer must be taken into account in the differential diagnosis of genital ulcers in adult women, even in those with an active sex life, and in recurrent cases. Given that it is a diagnosis of exclusion, it is always necessary to screen for sexually transmitted infections.FundingThe authors declare that no funding was received for this study.Conflicts ofinterestThe authors declare that they have no conflicts of interest." "textoCompletoSecciones" => array:1 [ "secciones" => array:3 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Funding" ] 1 => array:2 [ "identificador" => "sec0010" "titulo" => "Conflicts ofinterest" ] 2 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Morgado-Carrasco D, Bosch-Amate X, Fustà-Novell X, Giavedoni P. Úlcera de Lipschütz. una úlcera genital aguda no infecciosa para tener en cuenta en mujeres adultas. Actas Dermosifiliogr. 2020;111:624–626." ] ] "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 528 "Ancho" => 805 "Tamanyo" => 140511 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Lipschütz ulcer. Edema of the labia majora and multiple rounded ulcers with a fibrin base and a grayish halo distributed symmetrically on the labia majora. Note the typical symmetrical distribution (kissing ulcers)." ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0010" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "Source: Sehgal et al." "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Infectious \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Herpes simplex virus 1 and 2 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Epstein-Barr virus \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Varicella zoster virus \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Acute HIV infection \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Syphilis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Chancroid \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Venereal lymphogranuloma \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Leishmaniasis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Mycoplasma pneumoniae \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inflammatory \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Behçet disease \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Recurrent aphthosis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pyoderma gangrenosum \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Erosive lichen planus \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Crohn disease \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pharmacological \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fixed pigmented erythema \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Erythema multiforme \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Stevens-Johnson syndrome \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Toxic epidermal necrolysis \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ulcers caused by methotrexate or foscarnet \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Injury \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sexual abuse \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Contusions \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Dermatitis artefacta \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Neoplastic or preneoplastic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Squamous cell carcinoma \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Extramammary Paget disease \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Erythroplasia of Queyrat \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2383108.png" ] ] ] ] "descripcion" => array:1 [ "en" => "Etiology of Acute Genital Uulcers." ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lipschütz ulcers: should we rethink this? An analysis of 33 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "P. Vieira-Baptista" 1 => "J. Lima-Silva" 2 => "J. Beires" 3 => "J. Martinez-de-Oliveira" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejogrb.2015.07.016" "Revista" => array:6 [ "tituloSerie" => "Eur J Obstet Gynecol Reprod Biol" "fecha" => "2016" "volumen" => "198" "paginaInicial" => "149" "paginaFinal" => "152" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26297242" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Úlceras genitales artefactas de aparición simultánea en pareja" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Hernández-Gil" 1 => "M.V. Guiote" 2 => "A. Vilanova" 3 => "F. Mendoza" 4 => "J. Linares" 5 => "R. Naranjo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Actas Dermo-Sifiliogr" "fecha" => "2006" "volumen" => "97" "paginaInicial" => "122" "paginaFinal" => "125" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Úlceras vulvares agudas de Lipschütz" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.M. Martín" 1 => "I. Molina" 2 => "D. Ramón" 3 => "R. Alpera" 4 => "Frutos E de" 5 => "L García" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Actas Dermo-Sifiliogr" "fecha" => "2004" "volumen" => "95" "paginaInicial" => "224" "paginaFinal" => "226" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Non–Sexually Related Acute Genital Ulcers in 13 Pubertal Girls: A Clinical and Microbiological Study" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "D. Farhi" 1 => "J. Wendling" 2 => "E. Molinari" 3 => "J. Raynal" 4 => "G. Carcelain" 5 => "P. Morand" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archdermatol.2008.519" "Revista" => array:7 [ "tituloSerie" => "Arch Dermatol" "fecha" => "2009" "volumen" => "145" "paginaInicial" => "38" "paginaFinal" => "45" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19153341" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1888989115001639" "estado" => "S300" "issn" => "18889891" ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Lipschütz ulcer in a 17-month-old girl: a rare manifestation of Epstein–Barr primoinfection" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. Burguete Archel" 1 => "M. Ruiz Goikoetxea" 2 => "E. Recari Elizalde" 3 => "X. Beristain Rementería" 4 => "L. Gómez Gómez" 5 => "A. Iceta Lizarraga" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00431-013-2013-8" "Revista" => array:7 [ "tituloSerie" => "Eur J Pediatr" "fecha" => "2013" "volumen" => "172" "paginaInicial" => "1121" "paginaFinal" => "1123" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23636284" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S1888989111000760" "estado" => "S300" "issn" => "18889891" ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nonspecific genital ulcers" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "V.N. Sehgal" 1 => "D. Pandhi" 2 => "A. Khurana" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Clin Dermatol" "fecha" => "2014" "volumen" => "32" "paginaInicial" => "259" "paginaFinal" => "274" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/15782190/0000011100000007/v1_202009190930/S1578219020302067/v1_202009190930/en/main.assets" "Apartado" => array:4 [ "identificador" => "6157" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Case and Research Letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011100000007/v1_202009190930/S1578219020302067/v1_202009190930/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020302067?idApp=UINPBA000044"]

Estadísticas

Case and Research Letters

Lipschütz Ulcer: An Acute Noninfectious Genital Ulcer to Bear in Mind in Adult Women

Úlcera de Lipschütz. Una úlcera genital aguda no infecciosa para tener en cuenta en mujeres adultas

D. Morgado-Carrasco

Autor para correspondencia

morgado@clinic.cat

Corresponding author.

, X. Bosch-Amate, X. Fustà-Novell, P. Giavedoni

Servicio de Dermatología, Hospital Clínic de Barcelona, Universitat de Barcelona, Barcelona, Spain

Leído

12924

Veces
se ha leído el artículo

2041

Total PDF

10883

Total HTML

Compartir estadísticas

 array:25 [
  "pii" => "S1578219020302067"
  "issn" => "15782190"
  "doi" => "10.1016/j.adengl.2018.12.018"
  "estado" => "S300"
  "fechaPublicacion" => "2020-09-01"
  "aid" => "2324"
  "copyright" => "AEDV"
  "copyrightAnyo" => "2020"
  "documento" => "simple-article"
  "crossmark" => 1
  "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
  "subdocumento" => "crp"
  "cita" => "Actas Dermosifiliogr. 2020;111:624-6"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "Traduccion" => array:1 [
    "es" => array:20 [
      "pii" => "S0001731020300806"
      "issn" => "00017310"
      "doi" => "10.1016/j.ad.2018.12.011"
      "estado" => "S300"
      "fechaPublicacion" => "2020-09-01"
      "aid" => "2324"
      "copyright" => "AEDV"
      "documento" => "simple-article"
      "crossmark" => 1
      "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
      "subdocumento" => "crp"
      "cita" => "Actas Dermosifiliogr. 2020;111:624-6"
      "abierto" => array:3 [
        "ES" => true
        "ES2" => true
        "LATM" => true
      ]
      "gratuito" => true
      "lecturas" => array:1 [
        "total" => 0
      ]
      "es" => array:11 [
        "idiomaDefecto" => true
        "cabecera" => "<span class="elsevierStyleTextfn">CARTA CIENT&#205;FICO-CL&#205;NICA</span>"
        "titulo" => "&#218;lcera de Lipsch&#252;tz&#46; Una &#250;lcera genital aguda no infecciosa para tener en cuenta en mujeres adultas"
        "tienePdf" => "es"
        "tieneTextoCompleto" => "es"
        "paginas" => array:1 [
          0 => array:2 [
            "paginaInicial" => "624"
            "paginaFinal" => "626"
          ]
        ]
        "titulosAlternativos" => array:1 [
          "en" => array:1 [
            "titulo" => "Lipsch&#252;tz ulcer&#58; an acute noninfectious genital ulcer to bear in mind in adult women"
          ]
        ]
        "contieneTextoCompleto" => array:1 [
          "es" => true
        ]
        "contienePdf" => array:1 [
          "es" => true
        ]
        "resumenGrafico" => array:2 [
          "original" => 0
          "multimedia" => array:7 [
            "identificador" => "fig0005"
            "etiqueta" => "Figura 1"
            "tipo" => "MULTIMEDIAFIGURA"
            "mostrarFloat" => true
            "mostrarDisplay" => false
            "figura" => array:1 [
              0 => array:4 [
                "imagen" => "gr1.jpeg"
                "Alto" => 528
                "Ancho" => 805
                "Tamanyo" => 140511
              ]
            ]
            "descripcion" => array:1 [
              "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Edema de labios mayores y m&#250;ltiples &#250;lceras redondeadas con base de fibrina y halo gris&#225;ceo&#44; distribuidas sim&#233;tricamente en los labios mayores&#46; Se puede observar la t&#237;pica imagen de distribuci&#243;n &#171;en beso&#187; &#40;<span class="elsevierStyleItalic">kissing ulcers</span>&#41;&#46;</p>"
            ]
          ]
        ]
        "autores" => array:1 [
          0 => array:2 [
            "autoresLista" => "D&#46; Morgado-Carrasco, X&#46; Bosch-Amate, X&#46; Fust&#224;-Novell, P&#46; Giavedoni"
            "autores" => array:4 [
              0 => array:2 [
                "nombre" => "D&#46;"
                "apellidos" => "Morgado-Carrasco"
              ]
              1 => array:2 [
                "nombre" => "X&#46;"
                "apellidos" => "Bosch-Amate"
              ]
              2 => array:2 [
                "nombre" => "X&#46;"
                "apellidos" => "Fust&#224;-Novell"
              ]
              3 => array:2 [
                "nombre" => "P&#46;"
                "apellidos" => "Giavedoni"
              ]
            ]
          ]
        ]
      ]
      "idiomaDefecto" => "es"
      "Traduccion" => array:1 [
        "en" => array:9 [
          "pii" => "S1578219020302067"
          "doi" => "10.1016/j.adengl.2018.12.018"
          "estado" => "S300"
          "subdocumento" => ""
          "abierto" => array:3 [
            "ES" => true
            "ES2" => true
            "LATM" => true
          ]
          "gratuito" => true
          "lecturas" => array:1 [
            "total" => 0
          ]
          "idiomaDefecto" => "en"
          "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020302067?idApp=UINPBA000044"
        ]
      ]
      "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731020300806?idApp=UINPBA000044"
      "url" => "/00017310/0000011100000007/v1_202009110631/S0001731020300806/v1_202009110631/es/main.assets"
    ]
  ]
  "itemSiguiente" => array:20 [
    "pii" => "S1578219020301979"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2020.06.002"
    "estado" => "S300"
    "fechaPublicacion" => "2020-09-01"
    "aid" => "2397"
    "copyright" => "AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "cor"
    "cita" => "Actas Dermosifiliogr. 2020;111:627"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Chilblain and Acral Purpuric Lesions in COVID-19"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:1 [
          "paginaInicial" => "627"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "<span class="elsevierStyleItalic">Chilblain</span> y lesiones purp&#250;ricas acrales en COVID-19"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "V&#46; Wiwanitkit"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "V&#46;"
              "apellidos" => "Wiwanitkit"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731020301940"
        "doi" => "10.1016/j.ad.2020.06.002"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731020301940?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020301979?idApp=UINPBA000044"
    "url" => "/15782190/0000011100000007/v1_202009190930/S1578219020301979/v1_202009190930/en/main.assets"
  ]
  "itemAnterior" => array:20 [
    "pii" => "S1578219020302092"
    "issn" => "15782190"
    "doi" => "10.1016/j.adengl.2019.01.022"
    "estado" => "S300"
    "fechaPublicacion" => "2020-09-01"
    "aid" => "2375"
    "copyright" => "AEDV"
    "documento" => "simple-article"
    "crossmark" => 1
    "licencia" => "http://creativecommons.org/licenses/by-nc-nd/4.0/"
    "subdocumento" => "crp"
    "cita" => "Actas Dermosifiliogr. 2020;111:623-4"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:11 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
      "titulo" => "Prevalence of Syphilis in Children Adopted From Russia"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "623"
          "paginaFinal" => "624"
        ]
      ]
      "titulosAlternativos" => array:1 [
        "es" => array:1 [
          "titulo" => "Prevalencia de s&#237;filis en ni&#241;os adoptados de Rusia"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:8 [
          "identificador" => "fig0005"
          "etiqueta" => "Figure 1"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr1.jpeg"
              "Alto" => 1030
              "Ancho" => 2092
              "Tamanyo" => 198991
            ]
          ]
          "detalles" => array:1 [
            0 => array:3 [
              "identificador" => "at0005"
              "detalle" => "Figure "
              "rol" => "short"
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Incidence of syphilis in Russia &#40;1995&#8211;2015&#41;&#46; Source&#58; Federal Statistics Service of the Russian Federation&#58; Available at&#58; <span class="elsevierStyleInterRef" id="intr0005" href="https://www.gks.ru">https&#58;&#47;&#47;www&#46;gks&#46;ru</span>&#46;</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "G&#46; Oliv&#225;n-Gonzalvo"
          "autores" => array:1 [
            0 => array:2 [
              "nombre" => "G&#46;"
              "apellidos" => "Oliv&#225;n-Gonzalvo"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "Traduccion" => array:1 [
      "es" => array:9 [
        "pii" => "S0001731020301721"
        "doi" => "10.1016/j.ad.2019.01.019"
        "estado" => "S300"
        "subdocumento" => ""
        "abierto" => array:3 [
          "ES" => true
          "ES2" => true
          "LATM" => true
        ]
        "gratuito" => true
        "lecturas" => array:1 [
          "total" => 0
        ]
        "idiomaDefecto" => "es"
        "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0001731020301721?idApp=UINPBA000044"
      ]
    ]
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020302092?idApp=UINPBA000044"
    "url" => "/15782190/0000011100000007/v1_202009190930/S1578219020302092/v1_202009190930/en/main.assets"
  ]
  "en" => array:16 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Case and Research Letters</span>"
    "titulo" => "Lipsch&#252;tz Ulcer&#58; An Acute Noninfectious Genital Ulcer to Bear in Mind in Adult Women"
    "tieneTextoCompleto" => true
    "saludo" => "To the Editor"
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "624"
        "paginaFinal" => "626"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "D&#46; Morgado-Carrasco, X&#46; Bosch-Amate, X&#46; Fust&#224;-Novell, P&#46; Giavedoni"
        "autores" => array:4 [
          0 => array:4 [
            "nombre" => "D&#46;"
            "apellidos" => "Morgado-Carrasco"
            "email" => array:1 [
              0 => "morgado@clinic.cat"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "cor0005"
              ]
            ]
          ]
          1 => array:2 [
            "nombre" => "X&#46;"
            "apellidos" => "Bosch-Amate"
          ]
          2 => array:2 [
            "nombre" => "X&#46;"
            "apellidos" => "Fust&#224;-Novell"
          ]
          3 => array:2 [
            "nombre" => "P&#46;"
            "apellidos" => "Giavedoni"
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Servicio de Dermatolog&#237;a&#44; Hospital Cl&#237;nic de Barcelona&#44; Universitat de Barcelona&#44; Barcelona&#44; Spain"
            "identificador" => "aff0005"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "cor0005"
            "etiqueta" => "&#8270;"
            "correspondencia" => "Corresponding author&#46;"
          ]
        ]
      ]
    ]
    "titulosAlternativos" => array:1 [
      "es" => array:1 [
        "titulo" => "&#218;lcera de Lipsch&#252;tz&#46; Una &#250;lcera genital aguda no infecciosa para tener en cuenta en mujeres adultas"
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 528
            "Ancho" => 805
            "Tamanyo" => 140511
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Lipsch&#252;tz ulcer&#46; Edema of the labia majora and multiple rounded ulcers with a fibrin base and a grayish halo distributed symmetrically on the labia majora&#46; Note the typical symmetrical distribution &#40;kissing ulcers&#41;&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Genital ulcer is a common presenting complaint in clinical practice and may cause considerable anxiety for patients and their families&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Its etiology is diverse and includes infection&#44; inflammation&#44; drugs&#44; injury&#44; and tumors&#44; and diagnosis may prove challenging&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a> Lipsch&#252;tz ulcer is an acute noninfectious genital ulcer that has traditionally been reported in girls who have not yet started having sexual relations&#44;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> although it may be a frequent cause of genital ulcer in sexually active adult women&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> We report the case of a young woman with Lipsch&#252;tz ulcer&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">The patient was a 21-year-old woman with no history of disease and an active sex life who came to the emergency department with a 1-week history of very painful genital ulcers&#46; She also reported odynophagia and fever during the previous 3 days&#46; She denied having had sexual relations during the previous 2 months or having taken medication&#46; Physical examination revealed fever &#40;axillary temperature&#44; 37&#46;5&#8239;&#176;<span class="elsevierStyleSmallCaps">C</span>&#41;&#44; painful cervical lymph nodes&#44; and pharyngeal erythema&#46; We observed marked edema of the labia majora and multiple round ulcers with a fibrin base and grayish halo distributed symmetrically on both sides of the vulva &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Cultures taken from the pharynx and the genital ulcers and serology for Epstein-Barr virus &#40;EBV&#41;&#44; including heterophile antibody agglutination testing and IgM and IgG testing were negative&#46; Negative results were also recorded in serology testing for cytomegalovirus&#44; <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span>&#44; syphilis&#44; and HIV&#44; as well as in the polymerase chain reaction &#40;PCR&#41; assay of the sample of the ulcer for herpesvirus types 1 and 2&#44; <span class="elsevierStyleItalic">Treponema pallidum</span>&#44; venereal lymphogranuloma&#44; <span class="elsevierStyleItalic">Chlamydia trachomatis</span> &#40;serotypes D-K&#41;&#44; and <span class="elsevierStyleItalic">Haemophilus ducreyi&#46;</span> PCR was not performed for influenza virus or other respiratory viruses&#46; The patient was treated with ibuprofen 400&#8239; mg every 8 hours for 4 days&#44; eau de Goulard dressings&#44; and methylprednisolone 1&#37; cream for 10 days&#46; The patient&#8217;s condition progressed favorably with no complications&#46; Her pain was relieved&#44; and the ulcers healed in the following weeks&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">Lipsch&#252;tz ulcer is a disease of unknown origin characterized by acute painful and necrotic ulcers&#44; which have a classic symmetrical &#8220;kissing&#8221; pattern&#46; It is sometimes preceded by flu symptoms or mononucleosis-type symptoms and is common in young women and girls who have not yet started having sexual relations&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#44;4</span></a> Cases in children aged under 2 years are exceptional&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> As there are no clear diagnostic criteria&#44; Lipsch&#252;tz ulcer is considered a diagnosis of exclusion&#59; sexually transmitted infections must be ruled out as the main differential diagnosis &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> It is generally not necessary to perform a biopsy of the mucous membrane&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Etiology and pathogenesis seem to involve a hypersensitivity reaction to a virus or bacteria such as EBV&#44; <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span>&#44; cytomegalovirus&#44; influenza virus&#44; and <span class="elsevierStyleItalic">Salmonella</span>&#46; Consequently&#44; we observe immune complex deposition&#44; complement activation&#44; small vessel thrombosis&#44; and tissue necrosis&#46;<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;5&#44;6</span></a></p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Although Lipsch&#252;tz ulcer has been associated with children&#44; a recent publication that analyzed a series of 110 women with genital ulcers found that 30&#37; had been diagnosed with Lipsch&#252;tz ulcer at a mean age of 29 years &#40;10&#8211;79 years&#41; and that more than 80&#37; had started having sexual relations&#46; No patients had symmetrical &#40;kissing&#41; ulcers&#46; The most frequent finding was multiple ulcers in the vulvar vestibule&#44; although clinical expression was markedly polymorphic&#46; Up to 30&#37; had had a previous episode&#44; and an associated microorganism&#44; such as cytomegalovirus&#44; EBV&#44; <span class="elsevierStyleItalic">Mycoplasma pneumoniae</span>&#44; or parvovirus B19 was detected in 27&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">Lipsch&#252;tz ulcer generally resolves spontaneously in 2 to 3 weeks without scarring&#46; Management is based on support measures and control of pain&#46; The measures used include sitz bath &#40;warm water&#41;&#44; poultices&#47;dressings&#44; local cleansing&#44; oral analgesics &#40;nonsteroidal anti-inflammatory agents or paracetamol&#41;&#44; and topical anesthetics such as lidocaine 2&#37;&#46; In moderate to severe cases&#44; we can prescribe high-potency topical corticosteroids&#44; reserving systemic corticosteroids for cases with multiple necrotic lesions&#46; Oral antibiotics are only indicated in the case of superinfection of the ulcers or accompanying cellulitis&#46;<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> Lipsch&#252;tz ulcer can recur in up to one-third of patients&#46; In recurrent cases&#44; it is necessary to rule out Beh&#231;et disease&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Lipsch&#252;tz ulcer must be taken into account in the differential diagnosis of genital ulcers in adult women&#44; even in those with an active sex life&#44; and in recurrent cases&#46; Given that it is a diagnosis of exclusion&#44; it is always necessary to screen for sexually transmitted infections&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Funding</span><p id="par0040" class="elsevierStylePara elsevierViewall">The authors declare that no funding was received for this study&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Conflicts ofinterest</span><p id="par0045" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:3 [
        0 => array:2 [
          "identificador" => "sec0005"
          "titulo" => "Funding"
        ]
        1 => array:2 [
          "identificador" => "sec0010"
          "titulo" => "Conflicts ofinterest"
        ]
        2 => array:1 [
          "titulo" => "References"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Morgado-Carrasco D&#44; Bosch-Amate X&#44; Fust&#224;-Novell X&#44; Giavedoni P&#46; &#218;lcera de Lipsch&#252;tz&#46; una &#250;lcera genital aguda no infecciosa para tener en cuenta en mujeres adultas&#46; Actas Dermosifiliogr&#46; 2020&#59;111&#58;624&#8211;626&#46;</p>"
      ]
    ]
    "multimedia" => array:2 [
      0 => array:8 [
        "identificador" => "fig0005"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 528
            "Ancho" => 805
            "Tamanyo" => 140511
          ]
        ]
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0005"
            "detalle" => "Figure "
            "rol" => "short"
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Lipsch&#252;tz ulcer&#46; Edema of the labia majora and multiple rounded ulcers with a fibrin base and a grayish halo distributed symmetrically on the labia majora&#46; Note the typical symmetrical distribution &#40;kissing ulcers&#41;&#46;</p>"
        ]
      ]
      1 => array:8 [
        "identificador" => "tbl0005"
        "etiqueta" => "Table 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "detalles" => array:1 [
          0 => array:3 [
            "identificador" => "at0010"
            "detalle" => "Table "
            "rol" => "short"
          ]
        ]
        "tabla" => array:2 [
          "leyenda" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Source&#58; Sehgal et al&#46;</p>"
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Infectious&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Herpes simplex virus 1 and 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Epstein-Barr virus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Varicella zoster virus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Acute HIV infection&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Syphilis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Chancroid&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Venereal lymphogranuloma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Leishmaniasis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Mycoplasma pneumoniae</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Inflammatory&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Beh&#231;et disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Recurrent aphthosis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pyoderma gangrenosum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Erosive lichen planus&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Crohn disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Pharmacological&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Fixed pigmented erythema&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Erythema multiforme&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Stevens-Johnson syndrome&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Toxic epidermal necrolysis&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ulcers caused by methotrexate or foscarnet&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Injury&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Sexual abuse&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Contusions&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Dermatitis artefacta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Neoplastic or preneoplastic&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Squamous cell carcinoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Extramammary Paget disease&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Erythroplasia of Queyrat&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
              "imagenFichero" => array:1 [
                0 => "xTab2383108.png"
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Etiology of Acute Genital Uulcers&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "References"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "bibs0005"
          "bibliografiaReferencia" => array:6 [
            0 => array:3 [
              "identificador" => "bib0005"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lipsch&#252;tz ulcers&#58; should we rethink this&#63; An analysis of 33 cases"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "P&#46; Vieira-Baptista"
                            1 => "J&#46; Lima-Silva"
                            2 => "J&#46; Beires"
                            3 => "J&#46; Martinez-de-Oliveira"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/j.ejogrb.2015.07.016"
                      "Revista" => array:6 [
                        "tituloSerie" => "Eur J Obstet Gynecol Reprod Biol"
                        "fecha" => "2016"
                        "volumen" => "198"
                        "paginaInicial" => "149"
                        "paginaFinal" => "152"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26297242"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib0010"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#218;lceras genitales artefactas de aparici&#243;n simult&#225;nea en pareja"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "J&#46; Hern&#225;ndez-Gil"
                            1 => "M&#46;V&#46; Guiote"
                            2 => "A&#46; Vilanova"
                            3 => "F&#46; Mendoza"
                            4 => "J&#46; Linares"
                            5 => "R&#46; Naranjo"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Actas Dermo-Sifiliogr"
                        "fecha" => "2006"
                        "volumen" => "97"
                        "paginaInicial" => "122"
                        "paginaFinal" => "125"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib0015"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#218;lceras vulvares agudas de Lipsch&#252;tz"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;M&#46; Mart&#237;n"
                            1 => "I&#46; Molina"
                            2 => "D&#46; Ram&#243;n"
                            3 => "R&#46; Alpera"
                            4 => "Frutos E de"
                            5 => "L Garc&#237;a"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Actas Dermo-Sifiliogr"
                        "fecha" => "2004"
                        "volumen" => "95"
                        "paginaInicial" => "224"
                        "paginaFinal" => "226"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib0020"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Non&#8211;Sexually Related Acute Genital Ulcers in 13 Pubertal Girls&#58; A Clinical and Microbiological Study"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "D&#46; Farhi"
                            1 => "J&#46; Wendling"
                            2 => "E&#46; Molinari"
                            3 => "J&#46; Raynal"
                            4 => "G&#46; Carcelain"
                            5 => "P&#46; Morand"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1001/archdermatol.2008.519"
                      "Revista" => array:7 [
                        "tituloSerie" => "Arch Dermatol"
                        "fecha" => "2009"
                        "volumen" => "145"
                        "paginaInicial" => "38"
                        "paginaFinal" => "45"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19153341"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1888989115001639"
                          "estado" => "S300"
                          "issn" => "18889891"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0025"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Lipsch&#252;tz ulcer in a 17-month-old girl&#58; a rare manifestation of Epstein&#8211;Barr primoinfection"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => "E&#46; Burguete Archel"
                            1 => "M&#46; Ruiz Goikoetxea"
                            2 => "E&#46; Recari Elizalde"
                            3 => "X&#46; Beristain Rementer&#237;a"
                            4 => "L&#46; G&#243;mez G&#243;mez"
                            5 => "A&#46; Iceta Lizarraga"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1007/s00431-013-2013-8"
                      "Revista" => array:7 [
                        "tituloSerie" => "Eur J Pediatr"
                        "fecha" => "2013"
                        "volumen" => "172"
                        "paginaInicial" => "1121"
                        "paginaFinal" => "1123"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23636284"
                            "web" => "Medline"
                          ]
                        ]
                        "itemHostRev" => array:3 [
                          "pii" => "S1888989111000760"
                          "estado" => "S300"
                          "issn" => "18889891"
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0030"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Nonspecific genital ulcers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => "V&#46;N&#46; Sehgal"
                            1 => "D&#46; Pandhi"
                            2 => "A&#46; Khurana"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Clin Dermatol"
                        "fecha" => "2014"
                        "volumen" => "32"
                        "paginaInicial" => "259"
                        "paginaFinal" => "274"
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/15782190/0000011100000007/v1_202009190930/S1578219020302067/v1_202009190930/en/main.assets"
  "Apartado" => array:4 [
    "identificador" => "6157"
    "tipo" => "SECCION"
    "en" => array:2 [
      "titulo" => "Case and Research Letters"
      "idiomaDefecto" => true
    ]
    "idiomaDefecto" => "en"
  ]
  "PDF" => "https://static.elsevier.es/multimedia/15782190/0000011100000007/v1_202009190930/S1578219020302067/v1_202009190930/en/main.pdf?idApp=UINPBA000044&text.app=https://actasdermo.org/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1578219020302067?idApp=UINPBA000044"
]

Información del artículo

ISSN: 15782190
Idioma original: Inglés

DOI:10.1016/j.adengl.2018.12.018

Datos actualizados diariamente

año/Mes	Html	Pdf	Total

2024 Noviembre	29	9	38
2024 Octubre	243	57	300
2024 Septiembre	246	45	291
2024 Agosto	224	78	302
2024 Julio	239	42	281
2024 Junio	231	57	288
2024 Mayo	207	41	248
2024 Abril	247	29	276
2024 Marzo	265	35	300
2024 Febrero	229	41	270
2024 Enero	248	43	291
2023 Diciembre	250	19	269
2023 Noviembre	242	32	274
2023 Octubre	149	34	183
2023 Septiembre	121	45	166
2023 Agosto	110	16	126
2023 Julio	118	44	162
2023 Junio	111	30	141
2023 Mayo	149	34	183
2023 Abril	101	26	127
2023 Marzo	129	29	158
2023 Febrero	115	16	131
2023 Enero	84	29	113
2022 Diciembre	82	39	121
2022 Noviembre	70	36	106
2022 Octubre	57	25	82
2022 Septiembre	58	39	97
2022 Agosto	54	37	91
2022 Julio	50	33	83
2022 Junio	57	41	98
2022 Mayo	479	64	543
2022 Abril	533	51	584
2022 Marzo	513	68	581
2022 Febrero	368	36	404
2022 Enero	493	61	554
2021 Diciembre	508	48	556
2021 Noviembre	375	46	421
2021 Octubre	429	84	513
2021 Septiembre	314	46	360
2021 Agosto	340	32	372
2021 Julio	256	31	287
2021 Junio	279	33	312
2021 Mayo	328	48	376
2021 Abril	585	109	694
2021 Marzo	191	39	230
2021 Febrero	93	36	129
2021 Enero	71	18	89
2020 Diciembre	41	21	62
2020 Noviembre	30	17	47
2020 Octubre	62	26	88
2020 Septiembre	67	35	102
2020 Agosto	13	11	24

Mostrar todo

Indexada en:

Síguenos:

Estadísticas

Indexada en:

Síguenos:

Estadísticas

Suscríbase a la newsletter