Desquamative inflammatory vaginitis

Desquamative inflammatory vaginitis (DIV) is not a diagnosis in itself, and may be the presentation of a range of blistering disorders including pemphigus vulgaris, lichen planus and mucous membrane pemphigoid. The existence of an idiopathic subset of DIV remains controversial and is discussed in the present article. Desquamative inflammatory vaginitis is a rare but disabling condition. It presents in women of any age with a history of discomfort, irritation and painful sexual intercourse. Patients may also report an increased vaginal discharge. Examination of the vulva is normal, but erythematous regions on the vaginal walls are evident with increased vaginal secretion. This secretion is high in polymorphonuclear leukocytes, with an increased number of immature squamous epithelial cells. Repeated cultures are negative for bacteria, viruses and yeast. This is a sterile inflammatory vaginitis that can be difficult to treat, but successful therapy has been reported with topical steroids and clindamycin.