Abstract
A five-year-old girl had complained of vulvovaginal pruritus and discharge, following symptoms of allergic rhino-conjunctivitis for the past three grass pollen seasons. She was diagnosed as having allergic vulvovaginitis by the seasonal symptoms, the presence of serum grass pollen-specific IgE and an increased number of eosinophils in the vulvovaginal smear. Whereas treatment with hydroxyzine and oxatomide failed to control the pruritus, co-administration of pranlukast and epinastine hydrochloride ameliorated her symptoms, suggesting the involvement of cystinyl leukotriene in the pathophysiology of allergic vulvovaginitis and the usefulness of add-on of leukotriene antagonist for the treatment of refractory cases.