Intimate hygiene in atopic vulvar diseases in women with a history of somatic diseases

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Abstract

Background: Contact dermatitis of the vulva is one of the most common diagnoses in clinics dealing with vulvar pathology. Vulvar pruritis is the most frequent complaint of women visiting a gynecologist. Current causes of vulvar pruritus include not only comorbid conditions, vulvovaginal infections and diseases, but also an increase in vulvar irritants due to urbanization and aggressive intimate hygiene.

Case report: This article presents two clinical observations of patients receiving treatment for allergic dermatitis of the vulva; the women had uncompensated diabetes mellitus and took the drug empagliflozin. In the first case, a 64-year-old patient V. presented to the Department of Aesthetic Gynecology and Rehabilitation of the National Medical Research Centre for Obstetrics, Gynecology and Perinatology, with complaints of vulvar pruritus for a long time and erosions in the perineal area. After examination she was diagnosed with vulvar neurodermatitis which was caused by empagliflozin. In the second case, a 51-year-old patient R. presented to the Department of Aesthetic Gynecology and Rehabilitation of the National Medical Research Centre for Obstetrics, Gynecology and Perinatology, with complaints of itching in the vulva and anus, profuse curdy discharge from the genital tract for 6 months. She was diagnosed with vulvar neurodermatitis, recurrent candidal vulvovaginitis, exacerbation. Both patients underwent complex therapy including the use of intimate hygiene products, namely Saphorelle Gentle Cleansing gel and Saphorelle Intimate Moisturizing cream emollient. A visible clinical effect on the vulvar skin was noted after the therapy. It is recommended to continue proper intimate hygiene and perineal skin care with the Saphorelle products regularly.

Conclusion: Vulvar hygiene is based on the choice of a mild detergent capable of improving skin homeostasis from a physiologic pH value of 4.8 in the vaginal vestibule to 6–7 on the outer surface of the labia majora. The new line of the Saphorelle products supports the natural pH and microbiota of the vulva, fully complies with modern requirements for intimate hygiene of female genitalia and can also be used for vulvar diseases in the complex therapy of dermatoses and contact dermatitis according to the soak and seal method.

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About the authors

Tatiana A. Teterina

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Author for correspondence.
Email: palpebra@inbox.ru
ORCID iD: 0000-0003-0990-2302

PhD, Obstetrician-Gynecologist, USD, Department of Aesthetic Gynecology and Rehabilitation

Russian Federation, Moscow

Inna A. Apolikhina

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia; I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia (Sechenov University)

Email: i_apolikhina@oparina4.ru
ORCID iD: 0000-0002-4581-6295

Dr. Med. Sci., Professor, Head of the Department of Aesthetic Gynecology and Rehabilitation; Professor at the Department of Obstetrics, Gynecology, Perinatology, and Reproductology, Institute of Professional Education

Russian Federation, Moscow; Moscow

Anastasia E. Bychkova

Academician V.I. Kulakov National Medical Research Centre for Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia

Email: a_bychkova88@mail.ru
ORCID iD: 0000-0003-4855-8188

Obstetrician-Gynecologist, Department of Aesthetic Gynecology and Rehabilitation

Russian Federation, Moscow

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Supplementary files

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2. Fig. 1. External genitalia of patient B., 64 years old, diagnosed with vulvar neurodermatitis on empagliflozin (before treatment)

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3. Fig. 2. External genital appearance of patient B., 64 years old, diagnosed with vulvar neurodermatitis and type 2 DM on the background of empagliflozin and local therapy of vulvar neurodermatitis

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4. Fig. 3. Appearance of external genitalia of patient B., 64 y., diagnosed with vulvar neurodermatitis after 1 month against the background of changing the therapy of type 2 DM (switching to injections) and using only the emollient cream ‘Moisturising for intimate area Saphorel’

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5. Fig. 4. Appearance of external genitalia of patient R., 51 years old, diagnosed with vulvar neurodermatitis, RVVC and type 2 DM against the background of empagliflozin administration (before treatment)

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6. Fig. 5. Appearance of external genitalia of patient R., 51 years old, diagnosed with vulvar neurodermatitis, RVVC and type 2 DM after 3 months of topical therapy against the background of empagliflozin administration

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