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Annales de Dermatologie et de Vénéréologie
Vol 127, N° 4  - mai 2000
p. 377
Doi : AD-05-2000-127-4-0151-9638-101019-ART88
Mémoires originaux

Vulvodynie et dermographisme
 

J. Lübbe [1], A. Valiton [2], P. Pedrazetti [1], A. Arechalde [1], M. Harms [1]
[1]  Policliniques de Dermatologie, Hôpitaux Universitaires, Genève, Suisse.
[2]  et de Maternité, Hôpitaux Universitaires, Genève, Suisse.

Abstract
Introduction

La vulvodynie est un syndrome multifactoriel caractérisé par des plaintes vulvaires chroniques, associant prurit, sensations de brûlures et douleurs vulvaires. En l'absence de signes cliniques, ce syndrome est souvent perçu comme un problème principalement psychosomatique. Un contexte de dermographisme symptomatique a rarement été décrit.

Malades et méthodes

Dans notre consultation de dermatologie vulvaire, un test d'urticaire factice est systématiquement pratiqué, ce qui nous a permis de réunir 14 cas d'urticaires factices associés à une symptomatologie de vulvodynie dans une période de 17 mois.

Résultats

Les symptômes principaux étaient prurit, hyperesthésie vulvaire, et dyspareunie. Rapports sexuels, habits étroits et stress étaient les principaux facteurs d'aggravation. L'effet bénéfique d'un traitement antihistaminique systémique a été observé chez nos malades indiquant que certaines vulvodynies étaient une manifestation d'un dermographisme symptomatique d'expression vulvaire.

Discussion

La prise en charge initiale d'une vulvodynie devrait comporter un test d'urticaire factice. La prévalence d'une association causale entre une vulvodynie et une urticaire factice reste à être déterminée.

Abstract
Vulvodynia and facticious urticaria.
Background

The term vulvodynia describes a multifactorial syndrome of chronic vulvar discomfort with burning, itching, pain, and dyspareunia. Due to the paucity of clinical signs, this syndrome is often perceived as a predominantly psychiatric problem. A context of symptomatic dermographism has been reported in rare instances.

Patients and methods

In our interdisciplinary consultation of vulvar dermatology, we routinely look for the presence of facticious urticaria. In the last 17 months, we observed 14 patients with an association of facticious urticaria and vulvodynia.

Results

The principal symptoms were itching and burning. Sexual intercourse, tight clothes, and stress were most often cited as aggravating factors. The efficacy of a systemic antihistaminic treatment observed in our patients suggests that certain cases of vulvodynia might be an expression of symptomatic dermographism.

Discussion

Therefore, a check-up for chronic vulvar discomfort should comprise a test for the presence of facticious whealing. The prevalence of a causal relationship between chronic vulvar discomfort and facticious whealing remains to be established.






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