В работе рассмотрено разнообразие аллергических реакций в аногенитальной области, которые зачастую сопровождаются интенсивным зудом. Причиной зуда может стать как косметическое средство или сексуальная практика, так и хроническое дерматологическое заболевание. Тактика лечения аллергических реакций аногенитальной области заключается в исключении аллергена, назначении антигистаминных препаратов и подборе адекватных средств ухода как на время обострения, так и для повседневных гигиенических процедур.
Ключевые слова: зуд, аллергический дерматит, аногенитальная область.
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The article discusses a variety of allergic reactions in the anogenital area, which are often accompanied by intense pruritus. The cause of pruritus can be a cosmetic agent or sexual practice as well as a chronic dermatological disease. Treatment tactics for allergic reactions in the anogenital area relies on an exclusion of the allergen, a prescription of antihistamine agents and a selection of adequate care products for both an exacerbation period and everyday hygiene.
1. Kügler K, Brinkmeier T, Frosch PJ, Uter W. Anogenital dermatoses: allergic and irritative causative factors. Analysis of IVDK data and review of the literature. J Dtsch Dermatol Ges 2005; 3 (12): 979–86.
2. Eubel J, Diepgen TL, Weisshaar E. Allergic diseases in the genital area. Hautarzt 2015; 66 (1): 45–52.
3. Kroon S Allergy to human seminal plasma: a presentation of six cases. Acta Derm Venereol 1980; 60 (5): 436–9.
4. Elsner P, Wilhelm D, Maibach HI [Multiple parameter assessment of vulvar irritant contact dermatitis.Contact Dermatitis 1990; 23 (1): 20–6.
5. Friedman SA, Bernstein IL, Enrione M, Marcus ZH. Successful long-term immunotherapy for human seminal plasma anaphylaxis. JAMA 1984; 251 (20): 2684–7.
6. García Ortiz JC, Moyano JC, Alvarez M, Bellido J. Latex allergy in fruit-allergic patients. Allergy 1998; 53 (5): 532–6.
7. Farage M, Maibach HI. The vulvar epithelium differs from the skin: Implications for cutaneous testing to address topical vulvar exposures. Contact Dermatitis 2004; 51: 201–9.
8. Britz MB, Maibach HI. Human cutaneous vulvar reactivity to irritants. Contact Dermatitis 1979; 5: 375–7.
9. Johnson E, Groben P, Eanes A et al. Vulvar skin atrophy induced by topical glucocorticoids. J Midwifery Womens Health 2012; 57: 296–9.
10. Chan MP, Zimarowski MJ. Vulvar dermatoses: A histopathologic review and classification of 183 cases. J Cutan Pathol 2015; 42: 510–8.
11. Drummond C. Common vulval dermatoses. Aust Fam Physician 2011; 40: 490–6.
12. Warshaw EM, Furda LM, Maibach HI et al. Anogenital dermatitis in patients referred for patch testing: retrospective analysis of cross-sectional data from the North American Contact Dermatitis Group, 1994-2004. Arch Dermatol 2008; 144: 749–55.
13. Bhate K, Landeck L, Gonzalez E et al. Genital contact dermatitis: a retrospective analysis. Dermatitis 2010; 21 (6): 317–20.
14. Alwan W, White I, Bannerjee P. Presumed airborne contact allergy to methylisothiazolinone causing acute severe facial dermatitis and respiratory difficulty. Contact Dermatitis 2014; 70: 316–28.
15. Castanedo-Tardana M, Zug K. Methylisothiazolinone. Dermatitis 2013; 24 (1): 2–6.
16. Siddiqi S, Vijay V, Ward M et al. Pruritus ani. Ann R Coll Surg Engl 2008; 90: 457–63.
17. Trivedi MK, Woodruff CM, Kornik R, Botto N. Patch testing in vulvar allergic contact dermatitis. Dermatitis 2018; 29: 95–6.
18. Дворянкова Е.В., Невозинская З.А., Корсунская И.М. Дерматологические аспекты зуда вульвы в постменопаузе. Consilium Medicum. 2018; 20 (6): 50–2. DOI: 10.26442/2075-1753_2018.6.50-52 / Dvoryankova E.V., Nevozinskaya Z.A., Korsunskaya I.M. Dermatological aspects of pruritus vulvae in postmenopause. Consilium Medicum. 2018; 20 (6): 50–2. DOI: 10.26442/2075-1753_2018.6.50-52 [in Russian]
19. Курбачева О.М., Ильина Н.И., Лусс Л.В. Патогенетически обоснованный подход к лечению аллергического ринита: выбор антигистаминного препарата. РАЖ. 2007; 2: 83–8. / Kurbacheva O.M., Il'ina N.I., Luss L.V. Patogeneticheski obosnovannyi podkhod k lecheniiu allergicheskogo rinita: vybor antigistaminnogo preparata. RAZh. 2007; 2: 83–8. [in Russian]
20. Gispert J, Antonijoan R, Barbanoj M et al. Efficacy of Ebastine, Cetirizine, and Loratadine in histamine cutaneous challenges. Ann Allergy Asthma Immunol 2002; 89: 259–64.
21. Плиева К.Т., Мельниченко О.О., Невозинская З.А., Корсунская И.М. Возможности контроля кожных аллергических реакций. Эффективная фармакотерапия. Дерматовенерология и дерматокосметология. 2016; 3: 6–12. / Plieva K.T., Mel'nichenko O.O., Nevozinskaia Z.A., Korsunskaia I.M. Vozmozhnosti kontrolia kozhnykh allergicheskikh reaktsii. Effektivnaia farmakoterapiia. Dermatovenerologiia i dermatokosmetologiia. 2016; 3: 6–12. [in Russian]
22. Frossard N, Vital-Durand D, Mounedji N, Valleteau A. Duration of the antihistaminic effect after discontinuation of ebastine. Allergy 2001: 56: 553–7.
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1. Kügler K, Brinkmeier T, Frosch PJ, Uter W. Anogenital dermatoses: allergic and irritative causative factors. Analysis of IVDK data and review of the literature. J Dtsch Dermatol Ges 2005; 3 (12): 979–86.
2. Eubel J, Diepgen TL, Weisshaar E. Allergic diseases in the genital area. Hautarzt 2015; 66 (1): 45–52.
3. Kroon S Allergy to human seminal plasma: a presentation of six cases. Acta Derm Venereol 1980; 60 (5): 436–9.
4. Elsner P, Wilhelm D, Maibach HI [Multiple parameter assessment of vulvar irritant contact dermatitis.Contact Dermatitis 1990; 23 (1): 20–6.
5. Friedman SA, Bernstein IL, Enrione M, Marcus ZH. Successful long-term immunotherapy for human seminal plasma anaphylaxis. JAMA 1984; 251 (20): 2684–7.
6. García Ortiz JC, Moyano JC, Alvarez M, Bellido J. Latex allergy in fruit-allergic patients. Allergy 1998; 53 (5): 532–6.
7. Farage M, Maibach HI. The vulvar epithelium differs from the skin: Implications for cutaneous testing to address topical vulvar exposures. Contact Dermatitis 2004; 51: 201–9.
8. Britz MB, Maibach HI. Human cutaneous vulvar reactivity to irritants. Contact Dermatitis 1979; 5: 375–7.
9. Johnson E, Groben P, Eanes A et al. Vulvar skin atrophy induced by topical glucocorticoids. J Midwifery Womens Health 2012; 57: 296–9.
10. Chan MP, Zimarowski MJ. Vulvar dermatoses: A histopathologic review and classification of 183 cases. J Cutan Pathol 2015; 42: 510–8.
11. Drummond C. Common vulval dermatoses. Aust Fam Physician 2011; 40: 490–6.
12. Warshaw EM, Furda LM, Maibach HI et al. Anogenital dermatitis in patients referred for patch testing: retrospective analysis of cross-sectional data from the North American Contact Dermatitis Group, 1994-2004. Arch Dermatol 2008; 144: 749–55.
13. Bhate K, Landeck L, Gonzalez E et al. Genital contact dermatitis: a retrospective analysis. Dermatitis 2010; 21 (6): 317–20.
14. Alwan W, White I, Bannerjee P. Presumed airborne contact allergy to methylisothiazolinone causing acute severe facial dermatitis and respiratory difficulty. Contact Dermatitis 2014; 70: 316–28.
15. Castanedo-Tardana M, Zug K. Methylisothiazolinone. Dermatitis 2013; 24 (1): 2–6.
16. Siddiqi S, Vijay V, Ward M et al. Pruritus ani. Ann R Coll Surg Engl 2008; 90: 457–63.
17. Trivedi MK, Woodruff CM, Kornik R, Botto N. Patch testing in vulvar allergic contact dermatitis. Dermatitis 2018; 29: 95–6.
18. Dvoryankova E.V., Nevozinskaya Z.A., Korsunskaya I.M. Dermatological aspects of pruritus vulvae in postmenopause. Consilium Medicum. 2018; 20 (6): 50–2. DOI: 10.26442/2075-1753_2018.6.50-52 [in Russian]
19. Kurbacheva O.M., Il'ina N.I., Luss L.V. Patogeneticheski obosnovannyi podkhod k lecheniiu allergicheskogo rinita: vybor antigistaminnogo preparata. RAZh. 2007; 2: 83–8. [in Russian]
20. Gispert J, Antonijoan R, Barbanoj M et al. Efficacy of Ebastine, Cetirizine, and Loratadine in histamine cutaneous challenges. Ann Allergy Asthma Immunol 2002; 89: 259–64.
21. Plieva K.T., Mel'nichenko O.O., Nevozinskaia Z.A., Korsunskaia I.M. Vozmozhnosti kontrolia kozhnykh allergicheskikh reaktsii. Effektivnaia farmakoterapiia. Dermatovenerologiia i dermatokosmetologiia. 2016; 3: 6–12. [in Russian]
22. Frossard N, Vital-Durand D, Mounedji N, Valleteau A. Duration of the antihistaminic effect after discontinuation of ebastine. Allergy 2001: 56: 553–7.
1 ФГБУН «Центр теоретических проблем физико-химической фармакологии» РАН. 119991, Россия, Москва, Ленинский пр-т, д. 38а, корп. 1;
2 ГБУЗ «Московский научно-практический центр дерматовенерологии и косметологии» Департамента здравоохранения г. Москвы. 119071, Россия, Москва, Ленинский пр-т, д. 17
*marykor@bk.ru
1 Center for Theoretical Problems of Physicochemical Pharmacology of the Russian Academy of Sciences. 119991, Russian Federation, Moscow, Leninskiy pr-t, d. 38a, korp. 1;
2 Moscow Scientific and Practical Center of Dermatovenerology and Cosmetology of the Department of Health of Moscow.
119071, Russian Federation, Moscow, Leninskiy pr-t, d. 17
*marykor@bk.ru