The characteristics of the vulva pose various clinical problems with regard to vulvar toxicology. The vulva is a specialized skin with unique morphologic and functional properties, including increased permeability, higher degree of hydration, a proclivity to irritation as characterized by erythema, edema, and/or corrosion (1), and increased blood flow as compared to skin at other sites (2). Many of these qualities may increase the vulva's vulnerability to toxicities leading to dermatitis; however, the pigmented skin and structural qualities of the vulva make clinical diagnosis by physical examination difficult, as vulvar skin erythema is not readily visible. There is wide variation in physical presentation of vulvar dermatologic disease, making it difficult for the physician to ascertain the true diagnosis and etiology.

Because of these unique characteristics, heterogeneity of clinical findings, and difficulty in standardized access to the vulvar skin for controlled laboratory trials, the epidemiological data and the sensitivity and specificity of toxicological methods are poor; thus, researchers and clinicians have relied on clinical observation in order to validate the toxicological methods.

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