Allergic vulvovaginitis: a systematic literature review

Area of Science:

• Gynecology
• Allergology
• Immunology

Background:

• Vaginal allergic responses are under-investigated despite the mucosa's ability to react to allergens.
• Vulvovaginal allergies present unique diagnostic and etiological challenges in clinical practice.

Purpose of the Study:

• To identify common etiological agents of vulvovaginal allergies.
• To determine prevalent signs and symptoms associated with these allergies.
• To review diagnostic methods employed for vulvovaginal allergies.

Main Methods:

• A comprehensive literature search was conducted across major scientific databases (PubMed, Scopus, etc.).
• Studies were categorized based on allergen exposure routes (direct vs. indirect/unidentified).
• Subgroup analysis was performed for allergies related to Candida infection.

Main Results:

• Human Seminal Plasma was the primary allergen in direct exposure cases (73%), causing swelling and burning. Skin prick tests were common diagnostic tools.
• House dust mites (54%) and pollen (44%) were leading allergens in indirect exposure, with vulvar pruritus and burning as key symptoms.
• Candida antigen hypersensitivity was found in about half of women with co-existing allergy and Candida infection.

Conclusions:

• Direct antigen contact with the vulva/vagina is the most frequent cause of vulvovaginal allergic responses.
• Aeroallergens can also sensitize the vaginal mucosa indirectly.
• Understanding exposure routes is crucial for managing vulvovaginal allergies.