Dermatographia of the vulva is a cause of vulvar itching of allergic origin, when skin is touched, and can be put on the list of diagnoses in severe itching that doesn’t respond to antifungal drugs.1
Dermatographia patients will respond well to antihistamines where other types of medication has failed.2
Dermatographia Derma = skin Graphia = writing
Symptoms of dermatographia3
- Raised red lines on the skin, in this case the vulva
- Swelling
- Inflammation
- Burning
- Hives
- Welts
- Itching
- Stinging
- Usually a few minutes after being touched, rubbed or scratched
- Disappear within half an hour
- Slow versions exist that develop over several hours or days
- Condition may last for months or years (susceptibility)
- Triggers include sex, anything that touches the vulva, anything causing friction including tight clothes, riding a bike
- Antifungals and corticosteroids provide no relief
Diagnosing vulvar dermatographia
A scratch test on another part of the body can provide clues as to the diagnosis, but it’s not definitive. If there is a negative scratch test somewhere else on the body, like the abdomen, it does not rule out local vulvar dermatographia.4
Treating vulvar dermatographia
Treatments can include over-the-counter oral antihistamines5, but in the past some people have resorted to a vulvectomy – the complete removal of the vulva – to alleviate the itching and discomfort.
That is extreme, and very much off the cards with proper treatment for the allergic symptoms.
References
- 1.Rivera S, Mirowski GW. Dermatographism with vulvar symptoms. International Journal of Women’s Dermatology. Published online September 2021:454-457. doi:10.1016/j.ijwd.2021.04.008
- 2.Harlow BL, He W, Nguyen RHN. Allergic Reactions and Risk of Vulvodynia. Annals of Epidemiology. Published online November 2009:771-777. doi:10.1016/j.annepidem.2009.06.006
- 3.Rivera S, Mirowski G. 26420 Vulvar pain and pruritus secondary to dermatographism: An underrecognized etiology. Journal of the American Academy of Dermatology. Published online September 2021:AB18. doi:10.1016/j.jaad.2021.06.096
- 4.Cunningham KN, Rivera S, Holmes Seward S, Mirowski GW. Dermatographism With Genital Symptoms Treated With Antihistamines: A Case Series. J Cutan Med Surg. Published online March 22, 2024. doi:10.1177/12034754241238705
- 5.Kulthanan K, Ungprasert P, Tuchinda P, et al. Symptomatic Dermographism: A Systematic Review of Treatment Options. The Journal of Allergy and Clinical Immunology: In Practice. Published online October 2020:3141-3161. doi:10.1016/j.jaip.2020.05.016
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