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Vulvar dermatitis

Key sources
The following summarized guidelines for the evaluation and management of vulvar dermatitis are prepared by our editorial team based on guidelines from the European Academy of Dermatology and Venereology (EADV 2017).
1

Guidelines

1.Diagnostic investigations

Patch testing: obtain patch testing in patients with suspected allergic contact dermatitis.
B
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2.Diagnostic procedures

Biopsy: perform biopsy in patients with atypical features or failing to respond to treatment.
B

3.Medical management

Topical corticosteroids
Consider offering a topical corticosteroid in patients with vulvar dermatitis, such as:
hydrocortisone 1% ointment for mild cases
mometasone furoate or betamethasone valerate 0.025% ointment for severe cases
C
Apply topical corticosteroids once daily for 7-10 days until the symptoms and signs settle, and then as needed for any recurrent symptoms.
B

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4.Nonpharmacologic interventions

Avoidance of irritants and allergens: advise avoiding irritants and possible allergens, such as cleansers, fragrances and wet wipes in patients with vulvar dermatitis.
B

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  • Emollients

5.Follow-up and surveillance

Indications for referral: refer patients with urinary incontinence for urological and gynecological investigations.