Contact Vulvitis

Introduction

• Description: Contact vulvitis is characterized by vulvar irritation caused by contact with an irritant or allergen.

• Prevalence: Relatively common. Contact dermatitis accounts for roughly half of cases of vulvar itching.

• Predominant Age: Any, but most common in reproductive and menopausal years.

• Genetics: No genetic pattern.

Etiology and Pathogenesis

• Causes: Irritants may be primary or immunologic in character. The list of potential irritants can be extensive, including excessive hygiene (“feminine hygiene” sprays, deodorants and deodorant soaps, wipes, tampons, or pads—especially those with deodorants or perfumes), tight-fitting undergarments or those made of synthetic fabric, colored or scented toilet paper, and laundry soap or fabric softener residues. Even topical contraceptives, latex condoms, lubricants, “sexual aids,” or semen may be the source of irritation. Soiling of the vulva by urine or feces can also create significant symptoms. Severe dermatitis of the vulva resulting from contact with poison ivy or poison oak is occasionally observed.

• Risk Factors: Exposure to allergen (most often cosmetic or local therapeutic agents), immunosuppression, or diabetes.

Signs and Symptoms

• Diffuse reddening of the vulvar skin accompanied by itching or burning

• Symmetric, red, edematous change in the tissues

• Ulceration with weeping sores and secondary infection possible

Diagnostic Approach