Allergic Contact Dermatitis of the Anogenital Region in Men and Women

Abstract

Objectives Allergic contact dermatitis is an uncommon but important cause of skin disease in the anogenital region. Relevant allergens are described in women and less commonly in men. The aim of this study was to describe outcomes of patch testing in men and women presenting with anogenital dermatoses. Materials and Methods Cases patch tested for anogenital conditions at 2 patch test clinics in Sydney, Australia, from 2002 to 2017 were reviewed. Positive and relevant patch test reactions were recorded. Results Thirty-seven women and 27 men were included. Dermatitis was the most common diagnosis, followed by psoriasis and lichen sclerosus. Thirty percent had a final diagnosis of allergic contact dermatitis. The most frequent relevant allergens were fragrance mix I (9%), patients own products (9%), Myroxylon pereirae (8%), cocamidopropyl betaine (3%), and benzocaine (3%). Conclusions The top positive and relevant allergens seen were in concordance with other reports from Australia and the rest of the world. Fragrances and medicaments are common allergens, and it is recommended that products used on anogenital skin be fragrance free. Testing patients own products is imperative.

Reply

“…Fifteen (23%) of the 64 were considered atopic and not allergic. 3 Nonetheless, we agree with the authors and should be clear with patients that the provision of wipes at the clinic is for their comfort during examination and that we do not recommend the regular use of wipes at home.…”

A systematic review of allergic and irritant contact dermatitis of the vulva: The most important allergens/irritants and the role of patch testing

“…Of the included studies, 16 studies had a cross‐sectional design, of which nine were retrospective in which databases were used to conduct the study 13–21 . One randomized controlled trial was included 22 .…”

“…The mean age of the total study population was not always provided. The mean age ranged between 35.3 and 59.4 years in the studies that provided this information ( n = 13) 13–20,23,25,27–29 . Of all studies, 14 included post‐menopausal women 13–23,25,28,29 .…”

A baseline patch test series for New Zealand

“…Benzocaine has recently been replaced by caine mix III in the European baseline series due to superior performance in detecting anaesthetic sensitisation 28 . Topical anaesthetic allergy commonly manifests as anogenital dermatitis due to haemorrhoid preparations 29 . The publicly funded topical haemorrhoid preparations in New Zealand, Ultraproct (AFT Pharmaceuticals, Auckland, New Zealand) and Proctosedyl (Sonafi‐Aventis New Zealand Limited, Auckland, New Zealand) contain cinchocaine and a topical corticosteroid.…”

“…28 Topical anaesthetic allergy commonly manifests as anogenital dermatitis due to haemorrhoid preparations. 29 The publicly funded topical haemorrhoid preparations in New Zealand, Ultraproct (AFT Pharmaceuticals, Auckland, New Zealand) and Proctosedyl (Sonafi-Aventis New Zealand Limited, Auckland, New Zealand) contain cinchocaine and a topical corticosteroid. We have included caine mix III in the NZBS as this contains cinchocaine as well as benzocaine and tetracaine.…”