"The time to diagnosis of perianal streptococcal dermatitis is ≥3 weeks in 65% of cases." Because perianal cellulitis is commonly misdiagnosed, it is imperative that the proper diagnosing procedures are followed when encountering these symptoms, as delayed detection can result in severe complications.Within the pediatric population, it is common for the management of rashes to occur under the collaboration of an inter-professional team. Due to the diverse causes of rashes in the pediatric population, it may be necessary to refer pediatric patients to a pediatrician or a dermatologist to prevent misdiagnosis of perianal streptococcal dermatitis. Across the different disciplines of care, nurses have an opportunity to provide education on proper hygiene techniques to reduce the risk of recurrent infection. Pharmacists can provide patient and caretaker counseling on the selected medication therapy and improve medication adherence. By working together as an inter-professional team, all types of clinicians can improve patient health outcomes by raising awareness and reducing both time to diagnosis and the rate of recurrence of perianal streptococcal dermatitis infection. Differential diagnosis
Due to the non-specific presentation of the symptoms of perianal streptococcal dermatitis, it is frequently misdiagnosed by clinicians. To reach the correct diagnosis of perianal streptococcal dermatitis often ranges from weeks to months and can extend to even longer. During this time, the patient can undergo treatment for a variety of differential diagnoses.
Lipschütz ulcer, ulcus vulvae acutum or reactive non-sexually related acute genital ulcers (English: acute ulceration of the vulva) is a rare disease characterized by painful genital ulcers, fever, and lymphadenopathy, occurring most commonly, but not exclusively, in adolescents and young women. Previously, it was described as being more common in virgins. It is not a sexually transmitted disease, and is often misdiagnosed, sometimes as a symptom of Behçets disease.Lipschütz ulcer is named after Benjamin Lipschütz, who first described it in 1912. The cause is still unknown, although it has been associated with several infectious causes, including paratyphoid fever, cytomegalovirus, Mycoplasma pneumoniae and Epstein–Barr virus infection

Signs and symptoms
The most common presentation is a single large, deep ulcer (although several smaller ulcers may occur) in the internal surface of one or both labia minora. The labia majora may be affected, as may the vagina and urethra. The ulcer develops very quickly, and is usually preceded by sudden onset of fever and malaise. Diagnosis
The diagnosis is mainly clinical and centred in eliminating other more common causes for vulvar ulcers. Nevertheless, it has been proposed that Epstein-Barr detection using polymerase chain reaction for virus genome can help to reach sooner a diagnosis. Treatment
Treatment is symptomatic, and usually of little value; in most cases, the ulcer heals spontaneously within four to six weeks, sometimes leaving scars. Topical analgesics and anesthetics, as well as topical application of disinfectants/astringents such as potassium permanganate (in sitz baths), is commonly used.