Dr Lynda Spelman

Vulval pruritus is often a debilitating symptom that can have a profound impact on quality of life. It can be the result of inflammatory, infectious, or neoplastic conditions. Among causes inflammatory dermatoses are the most prevalent cause of itch. The prevalence of vulvaI itch in the general population is 5-10%, however it comprises up to 70% of presentations to specialists managing vulva! conditions. A retrospective audit of patients referred for persistent vulval irritation to a specialist dermatology outpatient clinic was conducted between 2018 and 2025, focusing on cases of suspected allergic contact dermatitis. 40 patients were patch tested using the Australian Baseline Series (ABS). There was a history of atopy in 62.5% of patients. 97.5% of patients had a positive reaction. The most common implicated allergens were Ammonium persulfate affecting 60% of patients, Hydroperoxides of Limonene (52.5%) and Nickel sulfate (50%). Personal product patch testing was performed in 77.5% of cases, with 66.9% reacting to at least one product category. The most commonly associated product classes were non­ shampoo shower products (78.9%), shampoo (64.3%) and laundry products (58%). This retrospective audit discovers sensitising agents in patients referred for persistent vulva! symptoms and identifies trends in allergens. Notably, most patients were referred by a single gynaecologist, potentially reflecting a subset of more treatment-refractory cases and limiting generalisability. We will discuss diagnostic challenges, prevalent allergen patterns and management strategies for patients in whom patch testing may not be feasible.