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 and outcomes of 60 patients seen in a referral dermatology clinic for vulvodynia. The composite patient profile is that of a 44-year-old white woman with a 2-year history of vulvar burning who has tried multiple topical therapies. Dermatological factors in these patients included candidiasis (37%), atopy (27%), dermatographism (27%), and irritant contact dermatitis (83%). Identification of these factors and directed management led to symptomatic improvement in 72% of patients within 4 months. No patients were treated with amitriptyline. A dermatological approach to discern the contributing factors for individual patients with vulvodynia can be helpful in directing therapeutic management.