Vulvodynia: A dermatologist's perspective with emphasis on an irritant contact dermatitis component

Vulvodynia (vulvar burning and itching) is a symptom complex with a number of potential triggering/exacerbating factors. We reviewed the management an d outcomes of 60 patients seen in a referral dermatology clinic for vulvody nia. The composite patient profile is that of a 44-year-old white woman wit h a 2-year history of vulvar burning who has tried multiple topical therapi es. Dermatological factors in these patients included candidiasis (37%), at opy (27%), dermatographism (27%), and irritant contact dermatitis (83%). Id entification of these factors and directed management led to symptomatic im provement in 72% of patients within 4 months. No patients were treated with amitriptyline. A dermatological approach to discern the contributing facto rs for individual patients with vulvodynia can be helpful in directing ther apeutic management.