Dermatitis de contacto alérgica e irritativa en región vulvar. Impacto de los jabones íntimos

  • Adriana Patricia Cruz Garnica
  • Sonia Salamanca
  • Natalia Hernández
  • Johanna Alexandra Villamil
  • Diana Carolina Quiasua
Palabras clave: Dermatitis de contacto, eccema, vulva, jabones, pruebas del parche. Dermatitis Allergic Contact, Eczema, vulva, Soaps, patch tests


La dermatitis de contacto vulvar es un problema común en dermatología y ginecología; afecta de manera importante la salud y la calidad de vida de las mujeres que la padecen. Más del 50% de los casos de prurito vulvar crónico en mujeres adultas puede ser atribuido a sustancias irritantes y alérgenos, entre ellos los denominados jabones íntimos, cuyo uso es cada vez más frecuente. El principal síntoma de la dermatitis es irritación en la región vulvar; puede presentar síntomas como prurito, ardor y dolor. La dermatitis de contacto se produce después de la exposición a irritantes exógenos o alérgenos. Clínicamente son difíciles de diferenciar estas dos entidades; se requiere realizar una adecuada historia clínica, que indague sobre posibles alérgenos, realizar un examen físico completo y una prueba de parche, único método diagnóstico que confirma la dermatitis alérgica por contacto, para realizar un diagnóstico acertado e iniciar un tratamiento adecuado y eliminar el factor desencadenante.

Biografía del autor/a

Adriana Patricia Cruz Garnica

Dermatóloga, Universidad Nacional de Colombia

Sonia Salamanca

Ginecóloga, Universidad Javeriana

Natalia Hernández

Dermatóloga, Universidad Militar

Johanna Alexandra Villamil

Médica General, Universidad El Bosque

Diana Carolina Quiasua

Médica General, Universidad El Rosario

Referencias bibliográficas

Farage MA, Miller KW, Ledger WJ. Determining the cause of vulvovaginal symptoms. Obstet Gynecol Surv 2008;63(7):445-64. Lever WF, SchaumburgLever G. 1983. Histopathology of the Skin. Philadelphia, Lippincott,.

Bauer A, Rödiger C, Greif C, Kaatz M, Elsner P. Vulvar Dermatoses - Irritant and Allergic Contact Dermatitis of the Vulva. Dermatology 2005;210(2):143-149.

Hoyme UB, Buehler K: Anatomy and physiology of the vulva, the vagina and the cervix; in Elsner P, Martius J (eds): Vulvovaginitis. New York, Dekker, 1993, pp 275-284.

Thompson IO, van der Bijl P, van Wyk CW, van Eyk AD. A comparative light- microscopic, electron-microscopic and chemical study of human vaginal and buccal epithelium. Arch Oral Biol 2001;46(12):1091-8. S0003-9969(01)00082-6.

Elsner P, Wilhelm D, Maibach HI. Frictional properties of human forearm an vulvar skin: influence of age and correlation with transepidermal water loss and capacitance. Dermatologica 1990;181(2):88- 91.

Britz MB, Maibach HI, Anjo DM. Human percutaneous penetration of hydrocortisone: the vulva. Arch Dermatol Res 1980;267(3):313-6.

Guy RH, Potts RO, Francoeur ML. Skin barrier function and the mechanism(s) of percutaneous penetration. Acta Pharm Nord 1992;4(2):115.

Connor CJ, BS, Eppsteiner EE. Vulvar Contact Dermatitis. Proceedings in Obstetrics and Gynecology 2014;4(2):1-14.

Jones IS. A histological assessment of normal vulval skin. Clin Exp Dermatol. 1983;8(5):513-21.

Summers PR, Hunn J. Unique dermatologic aspects of the postmenopausal vulva. Clin Obstet Gynecol 2007;50(3):745-51.

Fischer GO. The commonest causes of symptomatic vulvar disease: a dermatologist's perspective. Australas J Dermatol 1996;37(1):12-8.

Bauer A, Geier J, Elsner P. Allergic contact dermatitis in patients with anogenital complaints. J Reprod Med 2000;45(8):649-54.

Willis CM, Stephens CJ, Wilkinson JD. Epidermal damage induced by irritants in man: a light and electron microscopic study. J Invest Dermatol 1989;93(5):695-9.

Bauer A. Regional contact dermatitis. In: Gebhardt M, Elsner P, Marks J, editors. Handbook of contact dermatitis. Malden, USA: Martin Dunitz Ltd.; 2000. p. 143-52.

De Groot AC, Beverdam EG, Ayong CT, Coenraads PJ, Nater JP. The role of contact allergy in the spectrum of adverse effects caused by cosmetics and toiletries. Contact Dermatitis 1988;19:195-201.

Fisher AA, Rietschel RL, Fowler JF. Fisher's contact dermatitis. 6th edition. Hamilton (ON): B C Decker; 2008.

Petersen LJ, Lyngholm AM, Arendt-Nielsen L. A novel model of inflammatory pain in human skin involving topical application of sodium lauryl sulfate. Inflamm Res 2010;59(9):775-81. doi: 10.1007/s00011-010-0189-1.

O'Gorman SM, Torgerson RR. Allergic contact dermatitis of the vulva. Dermatitis 2013;24(2):64-72. doi: 10.1097/DER.0b013e318284da33.

Marren P, Wojnarowska F, Powell S. Allergic contact dermatitis and vulvar dermatoses. Br J Dermatol 1992;126(1):52-6.

LeSellin J, Drouet M, Bonneau JC, Sabbah A: Enquête allergologique dans les dermatoses de contact génitales. Allerg Immunol Paris 1991; 23:127-128.

Fisher AA. Allergic reaction to feminine hygiene sprays. Arch Dermatol 1973;108:801.

Giroux L, Pratt MD. Contact dermatitis to incontinency pads in a (meth)acrylate allergic patient. Am J Contact Dermat 2002;13:143-145.

Hernandez N, Pabon LH. Dermatosis vulvares y pruebas epicutaneas de parch. Presentado como trabajo libre, congreso mundial de dermatología, Buenos Aires, 2007.

Braitman M. Contact dermatitis due to colored toilet tissue. AMA Arch Derm Syphilol 1952;65(6):727.

Braun-Falco O, Korting HC. Normal pH value of human skin. Hautarzt. 1986;37(3):126-9.

Tarun J, Susan J, Suria J, Susan VJ, Criton S. Evaluation of pH of Bathing Soaps and Shampoos for Skin and Hair Care. Indian J Dermatol 2014; 59(5):442-444.

Corazza M, Lauriola MM, Zappaterra M, Bianchi A, Virgili A. Surfactants, skin cleansing protagonists. J Eur Acad Dermatol Venereol 201;24(1):1-6. doi: 10.1111/j.1468-3083.2009.03349.x

Lodén M, Buraczewska I, Edlund F. The irritation potential and reservoir effect of mild soaps. Contact Dermatitis 2003;49(2): 91-96.

Angelini G, Rigano L. Dermatite da contatto da cosmetici. In: Angelini, G, Vena, GA, eds. Dermatologia professionale ed ambientale. ISED, Brescia, Italy, 1997, 703-706.

Ananthapadmanabhan KP, Moore DJ, Subramanyan K et al. Cleansing without compromise: the impact of cleansers on the skin barrier and the technology of mild cleansing. Dermatol Ther 2004;17:16-25.

Kuehl BL, Fyfe KS, Shear NH. Cutaneous cleansers. Skin Therapy Lett 2003; 8(3):1-4.

Friedman M, Wolf R. Chemistry of soaps and detergents: various types of commercial products and their ingredients. Clin Dermatol 1996;14(1): 7-13.

Attwood D, Florence AT. Surfactant system. Their chemistry pharmacy and biology. London: Chapman and Hall, 1983: 1-11.

Effendy I, Maibach HI. Surfactants and experimental irritant contact dermatitis. Contact Dermatitis 1995;33(4): 217-225.

37 Rosen MJ. Surfactants and interfacial phenomena. New York: John Wiley & Sons,1978:1-25.

Berardesca E. La detersione. In: Caputo, R, Monti, M, eds. Manuale Di Dermocosmetologia Medica. Raffaello Cortina Editore, Milano, Italy. 1995: 83-89.

Zografi G, Schott H, Swarbrick J. Interfacial phenomena. In: Gennaro AR (ed): Remington's pharmaceutical sciences. Easton: Mack, 1990: 257-272.

Singer MM, Tjeerdema RS. Fate and effects of the surfactant sodium dodecyl sulfate. Rev Environ Contam Toxic 1993:133:95-149.

Moran J, Addy M, Wase W G. Determination of mínimum inhibitory concentrations of comercial toothpastes using an agar dilution method. J Dent 1988: 16:27 - 31

Wade WG, Addy M. Antibacterial activity of some triclosan - containing toothpases and their ingredients. J Periodontol 1992: 63: 280 -282

Satar SA, Springthorpe VS, Karim Y, Loro P. Chemical desinfection of non - porous inanimate surfaces experimentally containated with four human pathogenic viruses, Epidem Inf 1989: 102:493 - 505.

Agner T. Noninvasive measuring methods for the investigations of irritant patch test reactios. A study of patients with hand eczema, atopic dermatitis and controls. Acta Derm Venereol Suppl (Stockh) 1992;173:1-26.

Scheuplein R, Ross L. Effects of surfactatns and solvents on the permability of epidermis. J Soc Cosmet Chem 1970;21:853 -873.

LaRoche G, Eisler R, Tarzwell C M. Bioassay procedures for oil and iol dispersant toxicity evaluation. J Water Pollut Contr 1970;42:1982 - 1989.

Lee CH, Maibach HI. The sodium lauryl sulfate model: an overview. Contact Dermatitis 1995;33(1):1-7.

Löffler H, Happle R. Profile of irritant patch testing with detergents: sodium lauryl sulphate, sodium laureth sulphate and alkyl polyglucoside. Contact Dermatitis 2003;48(1):26-32.

Effendy I, Maibach HI. Detergent and skin irritation. Clin Dermatol 1996;14(1):15-21.

Willis CM, Stephens CJM, Wilkinson JD. Differential effects of structurally unrelated chemical irritants on the density of proliferating keratinocytes in 48 h patch test reactions.. J Invest Dermatol 1992;99(4):449 - 453.

Willis CM, Stephens CJM, Wilkinson JD. Differential patterns of epidermal leukocyte infiltration in patch test reactions to structurally unrelated chemical irritants. J Invest Dermatol 1993;101(3):364- 370.

Reynold EF(ed): Martindale. The extra Pharmacopoeia. 30th edition. London: Pharmaceutical. 1993: 1215-1216.

Fisher's. Contact Dermatitis, 4th edn. Williams & Wilkins, Baltimore, Maryland, USA, 1995: 288-291 and 349-351.

Pigatto PD, Bigardi AS, Cusano F. Contact dermatitis to cocamidopropylbetaine is caused by residual amines: Relevance, clinical characteristics, and review of the literature. Am J Contact Dermatitis 1995;6(1):13-16.

Foti C, Mastrandrea V, Conserva A, Bonamonte D, Rigano L, Angelini G. Dermatite da contatto da detergenti. Ann Ital Dermatol Allergol 2003; 57: 1-7.

Gelmetti C, Colonna C. Dermocosmetologia Pediatrica. EDITEAM s.a.s., Febbraio, Bologna, Italy, 2005.

Fowler JF. Allergy to cocamide DEA. Am J Contact Dermatitis 1998;9(1):40- 41.

Pinola A, Estlander T, Jolanki R, Tarvainen K, Kanerva L. Occupational allergic contact dermatitis due to coconut diethanolamide (cocamide DEA). Contact Dermatitis 1993;29(5):262-265.

Korting HC, Herzinger T, Hartinger A, Kerscher M, Angerpointner T, Maibach HI. Discrimination of the irritancy potential of surfactants in vitro by two cytotoxicity assays using normal human keratinocytes, HaCaT cells and 3T3 mouse fibroblast: correlation with in vivo data from a soap chamber assay. J Dermatol Sci 1994;7(2): 119 - 129.

Harvell J, Bason MM, Maibach HI. In vitro skin irritation assays: relevance to human skin. Clin Toxicol 1992;30(3):359 - 369.

Lang G, Spengler J. Abstracts of the XIV I.F.S.C.C. (The International Federation of Societies of Cosmetic Chemists) Congress in Barcelona 1986; Cosmetics Toiletries 1988; 103: 17.

Froebe CL, Simion FA, Rhein LD, Cagan RH, Kligman A. Stratum corneum lipid removal by surfactants: relation to in vivo irritation. Dermatologica 1990;181(4): 277-283.

Emery B. Edwards L. The pharmacology of soaps. III. Irritant action of sodium alkyl sulphates of human skin. J Am Pharm Ass 1940;29(6): 254 - 255.

Bettley FR. The influence of soap on the permeability of the epidermis. Br J Dermatol 1961;73: 448 - 451.

Mezei M, Sager R W, Stewart WD, De Ruyter AL. Dermatitic efectos of non - ionic surfactants. J Pharm Sci 1966;55(6): 584 - 589.

Wilhelm K P, Cua AB, Wolf HH, Maibach HI. Surfactant - induced stratum corneum hidration in vivo: prediction of the irritation potential of anionic surfactants. J Invest Dermatol 1993;101(3):310 - 315.

Kligman AM, Wooding WM. A method for the measurement and evaluation of irritants on human skin. J Invest Dermatol 1967;49(1): 78 - 94.

Rhein LD, Simion FA. Surfactant interactions with skin. Surf Sci Ser 1991;32:33 - 49

Johnson AW. Overview: fundamental skin care - protecting the barrier. Dermatol Ther 2004;17: 1-5.

Blume-Peytavi U, Lavender T, Jenerowicz D, Ryumina I, Stalder JF, Torrelo A, et al. Recommendations from a European Roundtable Meeting on Best Practice Healthy Infant Skin Care. Pediatr Dermatol. 2016 May;33(3):311-21. doi: 10.1111/ pde.12819

Draelos ZD. The science behind skin care: Cleansers. J Cosmet Dermatol. 2018;17(1):8-14. doi: 10.1111/jocd.12469

Gardner HL: Contact vulvovaginitis: Primary irritant and allergic reactions; in Gardner HL, Kaufman RH (eds): Benign Diseases of the Vulva and the Vagina, ed 2. Boston, Hall Med- ical Publishers, 1980, pp 431-432.

Singh A, Prieto VG, Czelusta A, McClain KL, Duvic M. Adult Langerhans cell histiocytosis limited to the skin. Dematology 2003;207(2):157-161.

Cómo citar
Cruz Garnica AP, Salamanca S, Hernández N, Villamil JA, Quiasua DC. Dermatitis de contacto alérgica e irritativa en región vulvar. Impacto de los jabones íntimos. rev. asoc. colomb. dermatol. cir. dematol. [Internet]. 28 de abril de 2020 [citado 22 de marzo de 2023];27(4):239-58. Disponible en:


Los datos de descargas todavía no están disponibles.
Artículo de revisión