Patch testing for vulval symptoms: our experience with 282 patients.

BACKGROUND

Vulval allergic contact dermatitis (ACD) may be a primary disorder or may be associated with an underlying vulval dermatosis. Few studies have looked at the incidence of ACD and the allergens responsible for it.

AIMS: We report the incidence of vulval ACD and the responsible allergens in 282 patients investigated over a 6-year period in a large teaching hospital.

METHODS

We performed a retrospective case notes review of all patients investigated for vulval symptoms in our tertiary referral contact dermatitis investigation unit. A total of 282 patients underwent patch testing.

RESULTS

The overall incidence of ACD was 54%. The age range of patients was 14-89 years. Pruritus was the most common presenting symptom. Nickel was the most commonly found allergen, but was usually not relevant. Fragrances and topical antibiotics/anaesthetics were less commonly detected, but were almost always relevant to the presentation. Positive reactions were more commonly found in patients who had long-standing symptoms and/or had used many products in the vulval area.

CONCLUSIONS

Vulval ACD affects women of a wide age range, and presents with nonspecific symptoms such as pruritus and/or vulval irritation. Patients may have experienced symptoms for many years before presenting to a dermatologist. The diagnosis of vulval ACD is more common in those who have been exposed to many potential sensitizers.