Prospective study of patch testing in patients with vulval pruritus.
Forty-three patients with the primary complaint of vulval pruritus were recruited to take part in this prospective patch-testing study. A detailed questionnaire was administered to each and patch testing to an extended battery of allergens was undertaken. This included the European standard series, preservatives, corticosteroids and a battery of common over-the-counter topical vulval treatments. Analysis of demographic data and prior treatments used, and various other parameters, were studied in the context of patch-test results. This prospective study reports a very high rate of contact sensitivity in patients presenting with vulval pruritus, with 81.4% of those tested having at least one contact allergen detected. One or more clinically relevant allergens were found in 44% of the subjects patch tested. The variables found to predict a greater likelihood of a contact allergy were a biopsy diagnosis of vulval dermatitis, the use of multiple topical treatments, sexual inactivity and patients with severe pruritus on a self-reported scale. Most importantly, many clinically relevant allergens these patients reacted to were outside the European standard series. This highlights the need for an extended series in this patient population.
Haverhoek
Emma
E
Flinders Medical Centre and Royal Adelaide Hospital, Adelaide, South Australia, Australia. e_storer@hotmail.com
Reid
Catherine
C
Gordon
Lynne
L
Marshman
Gillian
G
Wood
Jane
J
Selva-Nayagam
Priya
P
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000485:Allergens / Q000009:adverse effects; D017449:Dermatitis, Allergic Contact / Q000150:complications* / Q000175:diagnosis; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects; D005260:Female; D006801:Humans; D008875:Middle Aged; D010328:Patch Tests / Q000379:methods; D011446:Prospective Studies; D011539:Pruritus Vulvae / Q000209:etiology* / Q000473:pathology; D012720:Severity of Illness Index; D012725:Sexual Behavior; D011795:Surveys and Questionnaires; D014844:Vulva / Q000473:pathology; D014845:Vulvar Diseases / Q000150:complications* / Q000473:pathology
D000485:Allergens; D003879:Dermatologic Agents