Allergic contact dermatitis of the vulva

Dermatitis. 2013 Mar-Apr;24(2):64-72. doi: 10.1097/DER.0b013e318284da33.

Abstract

Background and objectives: Allergic contact dermatitis (ACD) of the vulva arises as a primary condition or develops secondary to topical agents. We aimed to describe the incidence of ACD in patients presenting with vulvar symptoms and to identify the allergens of most importance.

Patients and methods: Using a database of the patch testing results from 3 geographically distinct sites, we identified patients tested to a gynecologic series between 2003 and 2010. Patients had patch testing to the standard European battery and a gynecologic series. Patch testing was in line with accepted universal methods: application on day 1, allergen removal and initial reading on day 3, and final reading on day 5.

Results: Ninety patients were included. Thirty-five (39%) had a relevant positive result. The 5 allergens with the highest number of cases with a relevant reaction were natural fragrance mix 2%, balsam of Peru, benzocaine 5%, fragrance mix 8%, and quaternium 15 1%. The most common gynecologic series allergen to cause a relevant reaction was terconazole.

Conclusions: Allergic contact dermatitis is a frequent finding in patients presenting with vulvar symptoms. We identified a relevant positive result to patch testing in 39%. We found fragrances, medicaments, and preservatives to be of most relevance.

MeSH terms

  • Adult
  • Aged
  • Allergens / adverse effects*
  • Anesthetics, Local / adverse effects
  • Balsams / adverse effects
  • Benzocaine / adverse effects
  • Dermatitis, Allergic Contact / diagnosis
  • Dermatitis, Allergic Contact / etiology*
  • Female
  • Humans
  • Methenamine / adverse effects
  • Methenamine / analogs & derivatives
  • Middle Aged
  • Patch Tests / methods
  • Perfume / adverse effects
  • Preservatives, Pharmaceutical / adverse effects
  • Vulvar Diseases / chemically induced*
  • Vulvar Diseases / diagnosis

Substances

  • Allergens
  • Anesthetics, Local
  • Balsams
  • Perfume
  • Preservatives, Pharmaceutical
  • Peruvian balsam
  • quaternium-15
  • Methenamine
  • Benzocaine