Lipschütz ulcers are genital ulcerations that occur infrequently in girls and young women and are often mistaken for genital herpes simplex lesions despite lack of sexual exposure or contact with oral cold sores. They appear to be caused by an immune response to the Epstein-Barr virus or other organisms, resulting in a type III hypersensitivity reaction. All too often, despite negative HSV cultures, the patient is not believed and some sort of sexual or other genital contact is assumed to have taken place.