Patients may need to be asked about use of potentially allergenic products.

To describe the incidence of allergic contact dermatitis in patients presenting with vulvar symptoms and to identify the most common allergens, investigators employed patch testing to a standard series and a gynecologic series. Ninety women with itching, burning, pain, or discharge in the vulvar area and a clinical suspicion of allergic contact dermatitis were tested.

The median number of patch tests applied per patient was 105. Of 90 patients, 62 had a positive result, and a relevant allergen was detected in 35. The most common relevant allergens detected by testing to the standard screen were fragrance, balsam of Peru, benzocaine, and quaternium 15. The top allergens detected in the gynecologic series were terconazole, benzoic acid, and parabens. Less common relevant allergens included metals (especially gold), topical antibiotics, and other antifungal agents. One patient had a relevant corticosteroid allergy. Relevant contact allergy was not more common in atopic patients. Women older than 70 years were more likely than younger women to have a relevant positive patch test result (62% vs. 32%). The most common clinical diagnosis in women with a relevant positive test was lichen sclerosis. Three patients reacted to methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) or methyldibromo glutaronitrile, which are preservative chemicals in certain toilet papers.

CITATION(S):

O'Gorman SM and Torgerson RR. Allergic contact dermatitis of the vulva. Dermatitis 2013 Mar; 24:64.