An acute non-infectious genital ulcer or Lipschütz ulcer after the AstraZeneca COVID (Vaxzevria®) vaccine was reported from Hospital de Galdakao-Usansolo, Spain.
A 24-year-old woman went to the emergency room with four excruciating ulcers on the labia majora.
She had received the vaccine from AstraZeneca (Vaxzevria®) 3 days before. She also had flu-like symptoms with fever and generalized joint pains.
She denied having had risky sex in the previous months and was not following any treatment.
She suffered the same problem nine months earlier, consisting of painful vulvar ulcers, fever, and malaise, which resolved in a few weeks with symptomatic treatment—an infectious and non-infectious cause as ruled out then.
The images below came from the case report.
Cultures and PCR tests were negative for herpes simplex virus type 1 and 2, syphilis, Mycoplasma genitalium, Trichomonas vaginalis, and gonorrhea.
Serologies for syphilis, HIV, and hepatitis A, B, and C viruses were also negative. In addition, the autoimmunity study was negative, and the patient was not a carrier of the HLA B51 or HLA B57 allele.
The patient was treated with a tapering dose of prednisone 30 mg and pain killers.
Within three weeks, the patient was asymptomatic, and the lesions had resolved.
The case was reported to the Spanish Pharmacovigilance System. According to its causality algorithm, the Lipschütz ulcer was considered “possibly related to the vaccine.”
Four other Lipschütz ulcer cases
In EudraVigilance, the European equivalent of VAERS in the US, four cases were vulvar ulcers (three of them specified Lipschütz ulcer).
The age ranges are from 18 to 25. The onset from vaccination with AstraZeneca to ulcer development is one to two days. All recovered except for one.
Acute non-infectious genital ulcer or Lipschütz ulcer mainly affects women under 20.
Lipschütz ulcer typically presents as a sudden appearance of one or more painful necrotic genital ulcers larger than 1 cm, located symmetrically in a mirror or “kiss.”
Generally, they appear in the context of a pseudo-influenza or infectious mononucleosis type and resolve spontaneously within three weeks.
Treatment is symptomatic and based on hygienic and analgesic measures.
Systemic corticosteroids are controversial since they could lengthen the duration of the picture, and they are reserved for the most severe cases with significant inflammation. As in this report, a third of the patients have some recurrence.
AstraZeneca’s ChAdOx-1-S SARS-CoV-2 vaccine is a monovalent vaccine composed of a recombinant, non-replicative chimpanzee adenovirus vector encoding the SARS-CoV-2 virus’ spike glycoprotein.
The five cases of Lipschütz ulcers reinforce the hypothesis that the immune response triggered by an infectious agent or its particles (vaccines) is responsible for the development of these lesions.
The case report is published in Actas Dermo-Sifiliográficas.
Update: A case report of a 12-year-old healthy girl without prior sexual activity that developed after the Pfizer “vaccine” has been reported.
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Reference:
González-Romero N, Morillo Montañes V, Vicente Sánchez I, García García M. Úlceras De Lipschütz Tras La Vacuna Frente A La Covid-19 De Astrazeneca [Lipschütz Ulcers After the AstraZeneca COVID-19 Vaccine]. Actas Dermosifiliogr (Engl Ed). 2021 Aug 2. Spanish. doi: 10.1016/j.ad.2021.07.004. Epub ahead of print. PMID: 34366434; PMCID: PMC8327554.
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