Collins test in patients with vulvar pruritus

Abstract

E-mail address: sicantal3@yahoo.com. Pruritus is the most common symptom of vulvar disorders. The prevalence of vulvar pruritus in the female population is unknown, as is the prevalence of most of the conditions responsible for the itching [1]. It is important to recognize that vulvar pruritus is a symptom and not a disease, and optimal management should be to search for the underlying cause of the problem so that appropriate treatment can be given. In particular, it is important to differentiate between benign, premalignant, and malignant conditions [1]. Biopsy is the primary diagnostic tool for vulvar lesions [2]. The important question here is to accurately determine the site of the biopsy. To increase the sensitivity and specificity of vulvar biopsy, Collins toluidine blue test can be used to define more accurately the areas of vulvar abnormalities [1]. The present study was conducted at Al-Yarmouk Teaching Hospital and Al-Habibiya Maternity Hospital in Baghdad, Iraq, between September 2004 and June 2005. A total of 100 women aged between 40 and 60 years suffering from vulvar pruritus of variable duration were included in the study. All women gavewritten consent for participation. Each patient had a full history taken and underwent a complete physical examination. Exclusion criteria were infections, contact dermatitis, psoriasis, seborrheic dermatitis, use of barrier contraception, ulcer or mass of the vulva, or any visible lesions of the vagina and cervix. To identify areas of vulvar abnormalities, toluidine blue was applied to the vulva. Dark blue colored areas that might represent abnormal skinwere biopsied. If therewas no abnormal staining, a biopsywas taken from the most pruritic areas of the vulva to detect false-negative cases. All biopsies were examined by one histopathologist.