Aetiological factors in vulvar dermatitis

Aim To determine aetiological factors in vulvar dermatitis. Background Dermatitis of the vulva is a common clinical diagnosis in the sp ecialized vulva clinic, although the exact prevalence is unknown. Aetiologi cal factors are poorly understood in particular the incidence of atopy and seborrhoeic dermatitis. Other factors implicated are iron deficiency and ex ogenous causes such as contact irritants and allergens. Methods During a 1-year period, 38 patients with an initial clinical diagno sis of vulvar dermatitis were questioned, examined and investigated with fu ll blood count, serum ferritin, bacterial swab where indicated and punch bi opsy. After three patients had been excluded with other diagnoses, prick te sting and patch testing were carried out. Results Of the 35 patients with vulvar dermatitis, 34 (97%) had either an a topic background and/or seborrhoeic dermatitis. Iron deficiency occurred in seven patients (20%) and relevant positive patch tests in nine patients (2 6%). Twenty patients had biopsies and all had confirmatory histology. Conclusion This study suggests that the main aetiological factor in vulvar dermatitis is an endogenous predisposition. Iron deficiency may also contri bute, while contact with irritants and allergens may explain the localizati on and frequently complicates and exacerbates the picture. Secondary sensit ization to multiple substances is common.