Eubel J, Diepgen T L, Weisshaar E
Universitätsklinikum Heidelberg, Thibautstraße 3, 69115, Heidelberg, Deutschland,
Hautarzt. 2015 Jan;66(1):45-52. doi: 10.1007/s00105-014-3561-1.
The genital area has a high exposure to various allergens that are not always obvious. Out of shame patients may not complain about symptoms in this area. Moreover, diagnosis and therapy are often not primarily conducted by a dermatologist and allergologist. Therefore, many cases of allergic diseases in the genital area remain undetected.
Which type I and type IV allergies occur in the genital area? Which allergens are currently of importance? Which are the characteristics of allergic diseases in the genital area? What are the symptoms and differential diagnoses? What to focus on when taking medical history and in clinical diagnostics?
The current medical literature regarding allergic diseases in the genital area is discussed.
In the genital area type IV allergies such as contact dermatitis exceed type I allergies in number. Contact urticaria can occur due to seminal plasma allergy, latex allergy and a transfer of type I allergens via semen. Contact allergens are found in sex products such as condoms, but also in topical products. Methylisothiazolinone has become a new and important contact allergen for the genital area in recent years. Also, fixed drug eruption occurs preferentially in the genital area. As a delayed type IV allergy due to systemically administered drugs it has to be considered in the differential diagnosis.
Presumably, there are a high number of unreported cases of allergic diseases in the genital area. Interdisciplinary collaboration between gynecologists, urologists and dermatologist should be increased. The use of methylisothiazolinone in rinse-off and leave-on products should be discussed.
生殖器区域极易接触到各种并不总是显而易见的过敏原。出于羞耻感,患者可能不会诉说该区域的症状。此外,诊断和治疗通常并非主要由皮肤科医生和过敏症专科医生进行。因此,生殖器区域的许多过敏性疾病病例仍未被发现。
生殖器区域会出现哪些I型和IV型过敏?目前哪些过敏原较为重要?生殖器区域过敏性疾病的特征是什么?症状和鉴别诊断有哪些?病史采集和临床诊断时应关注什么?
讨论了当前关于生殖器区域过敏性疾病的医学文献。
在生殖器区域,IV型过敏如接触性皮炎的数量超过I型过敏。接触性荨麻疹可因精浆过敏、乳胶过敏以及I型过敏原通过精液传播而发生。接触性过敏原不仅存在于避孕套等性用品中,也存在于外用产品中。近年来,甲基异噻唑啉酮已成为生殖器区域一种新的重要接触性过敏原。此外,固定性药疹也优先发生于生殖器区域。作为全身性用药引起的迟发型IV型过敏,在鉴别诊断时必须予以考虑。
推测生殖器区域存在大量未报告的过敏性疾病病例。应加强妇科医生、泌尿科医生和皮肤科医生之间的跨学科合作。应讨论在冲洗型和驻留型产品中使用甲基异噻唑啉酮的情况。