Genital contact allergy.

Irritant and allergic contact dermatitis is commonly seen in patients complaining of itching, burning and irritation in the genital area. The aim of this retrospective study was to establish the prevalence of allergic contact dermatitis patients with genital complaints. We followed 33 patients with persistent or recurrent genital redness, itching and burning sensation. Diagnosis was made by history, clinical examination and patch testing. Patch tests were carried out according to the International Contact Dermatitis Research Group with a standard series of allergens. We also tested topical pharmaceutical products that individual patients used for treating genital symptoms and patients self intimate hygiene products. There were 11 male and 22 female patients, mean age 38 years. Thirteen (39%) patients had one or more positive allergic reactions, mainly to nickel-sulfate, thimerosal, balsam of Peru, formaldehyde and neomycin sulfate. In seven of 13 patients with positive patch test results, these reactions were considered to be relevant to their clinical condition. Three patients had positive patch test reactions to their intimate hygiene products. One patient had positive patch test reaction to latex condom. Patients with genital symptoms are at a risk of developing contact sensitivity. Patch testing is useful in the management of these patients and many can be helped by allergen avoidance.

Löfgren's syndrome presenting with erythema nodosum-like eruption.

Löfgren's syndrome is an acute form of sarcoidosis that mostly presents with erythema nodosum, periarticular ankle inflammation, arthritis, conjunctivitis, and unilateral or bilateral hilar or right paratracheal lymphadenopathy. Erythema nodosum is the most common cutaneous lesion in acute sarcoidosis, but it is histologically nonspecific, as it does not reveal sarcoidal granulomas upon microscopic examination. We present a case of a 57-year-old woman with acute onset of tender erythematous nodules on the calves, which were clinically erythema nodosum-like lesions. Histologic analysis revealed sarcoidal granulomas located in the dermis and subcutaneous tissue. Upon further work-up, the patient was found to have both pulmonary and ocular sarcoidosis. Based on this case, we recommend that all patients with erythema nodosum-like lesions undergo biopsy and further work-up for sarcoidosis is recommended in case of biopsy proven sarcoidal granulomas.