Irritant and allergic contact dermatitis are commonly seen in patients complaining about itching, burning and irritation in the vulvar area. Irritation often precedes allergic sensitization. Clinically, irritant and allergic contact dermatitis can be difficult to distinguish. Diagnosis is made by history, clinical investigation and patch testing. Recommended patch test series are the standard series, a medicament series, the patient’s own topical medicaments, popular remedies and other suspected products. A skin biopsy may be useful to establish the diagnosis of contact dermatitis, but it is usually not helpful for the differential diagnosis between irritant and allergic dermatitis.

Refinement in procedures to assess skin surface water loss (SSWL) dynamics of the vulvar skin on a large sample of subjects (60) is described and compared to another semi-occluded skin site, the inner thigh. Vulvar SSWL significantly decreased over a 30-min period from 46.2 ± 2.6 (SE) to 24.7 ± 1.6 g m^–2 h (p < 0.001). The inner thigh, another semi-occluded region, showed no similar pattern for SSWL (6.2 ± 0.3 to 6.6 ± 0.5 g m^–2 h), and the values were significantly less than those for vulvar skin. There was no significant effect of age, body mass index or atopic status on vulvar SSWL.

Products intended for individuals in contact with strongly adhering dirt often contain grit. Various clinical test methods have been developed for evaluating the potential of personal washing products to induce skin irritation. In the present study, differences in the irritant effects of washing products containing naturally-derived grit and synthetic grit were investigated in a forearm wash test. The forearms of 16 test subjects were washed in a total of 18 treatments (4 per day for 4 days, with 2 treatments on the 5th day). Treatment consisted of continuous washing for 2 min by a technician, who gently slid his fingertips with the lather up and down the forearm. Non-invasive instrumental measurements of skin barrier function were performed. Repetitive washing for 1 week lead to increased TEWL values, skin redness and decreased stratum corneum hydration. Results indicate differences in irritancy potential due to different types of grit, their surface and concentration. It is concluded that the repeated wash test seems to be adequate for rating personal washing products that contain grit.

Background: Vulval diseases are common, but their frequency and importance are often underestimated. Objective: The study intended to evaluate the number of patients with vulval diseases seen in medical practice. Furthermore, the acceptance of an interdisciplinary vulval disease clinic, managed by a dermatologist in cooperation with a gynaecologist and a psychologist, was evaluated. Methods: In April and Mai 1998, a mailing survey of all gynaecologists (n = 239), general practitioners (n = 244) and dermatologists (n = 96) in Thuringia, Germany, containing 7 questions concerning patients with vulval diseases was performed. Results: 49% (n = 286) of the questionnaires were returned. On average, 97% of the physicians regularly treated females with genital diseases. The most common diseases mentioned by all specialities were local fungal and bacterial infections. The further ranking of diagnosis was different between the specialities. It was estimated that 83% of patients with chronic disorders would develop additional psychological problems. The necessity of an interdisciplinary vulval disease clinic in Thuringia was stated by 71% of the interviewed physicians. 76% of the gynaecologists and 75% of the general practitioners welcomed the introduction of the clinic. Interestingly, only 51% of the dermatologists felt that a vulval disease clinic was necessary. Conclusion: The majority of the physicians in Thuringia welcomed an interdisciplinary vulval disease clinic to improve the conditions for women suffering from genital diseases.

Giant condyloma (Buschke-Löwenstein tumour) is a rare pseudocancereous lesion. If human papilloma viruses of type 16 or 18 is demonstrated in the lesions, malignant degeneration should be considered. Histological examination is essential to differentiate it from squamous cell carcinoma.