Juvenile Gangrenous Vasculitis of the Scrotum or Scrotum Lipschütz Ulcers

ABSTRACT Lipschütz genital ulcers are traditionally described in adolescent females and often linked to acute viral infections. Their male counterpart remains poorly characterised. We report a 59‐year‐old man with sudden onset of unilateral necrotic ulcers on the scrotum and inguinal region following a brief febrile episode and mild pharyngitis. Examination revealed three sharply demarcated, mildly painful ulcers with necrotic bases. Extensive microbiologic testing excluded common infectious causes. Serology demonstrated primary Epstein–Barr virus (EBV) infection, confirmed by NAAT (Nucleic Acid Amplification Test) for EBV from ulcer material. A diagnosis of juvenile gangrenous vasculitis of the scrotum (JGVS) was made, a rare entity considered a potential male analogue of Lipschütz ulcers. The patient received only supportive care only and achieved complete healing within 2 weeks. This case, clearly associated with EBV, supports the hypothesis that JGVS and Lipschütz genital ulcers are sex‐specific manifestations of the same autoinflammatory process triggered by viral infections.