Vulvar pruritus secondary to hemochromatosis

Erica Hofland,Colleen K Stockdale

doi:10.17077/2154-4751.1253

Abstract

Background: While acute pruritus is often attributable to yeast vulvovaginitis, chronic pruritus can present as the result different conditions including manifestation of a systemic disorder. Case: A 27-year-old woman presented with a 3 year history of vulvar pruritus, burning, and dyspareunia consistent with contact dermatitis. She failed to improve despite treatment prompting evaluation for an underlying systemic disorder, such as iron deficiency anemia. Interestingly, elevated iron levels were identified leading to the diagnosis of hemochromatosis. Following treatment and near normalization of her serum iron levels, the patient’s vulvar symptoms improved. Conclusion: Vulvar pruritus is a symptom and not a disease. Thus it is important to search for the cause keeping in mind that dermatologic complaints such as pruritus can be the first manifestation of a systemic process.

Highlights

The approach to common causes of vulvar pruritus is based on the symptom duration, age of the patient, and whether or not the patient has other associated symptoms
To remain open to the possibility that vulvar pruritus may be the first manifestation of an underlying systemic disorder when symptoms persist despite adequate treatment and testing remains unrevealing.[1]
About 15 months after the initial evaluation, her symptoms became so significant that she was no longer able to apply topical medications without aggravating symptoms of vulvar irritation, burning, and pruritus. Throughout this time the labia and vestibule continued to appear erythematous on exam and repeat evaluations including microscopy, pH, and yeast cultures returned negative

Summary

Introduction

The approach to common causes of vulvar pruritus is based on the symptom duration (acute vs chronic), age of the patient (pre-menarche, reproductive age, or post-menopausal), and whether or not the patient has other associated symptoms. To remain open to the possibility that vulvar pruritus may be the first manifestation of an underlying systemic disorder when symptoms persist despite adequate treatment and testing remains unrevealing.[1] A 27-year-old G0 woman referred to our tertiary care center with a 3 year history of vulvar pruritus and burning incompletely relieved following application of local topical steroid creams.

Results

Conclusion