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Desquamative inflammatory vaginitis
1Dept. of Obstetric and Gynecology, Shaare Zedek medical Center, Hebrew University, Jerusalem, Israel.
Best Practice & Research. Clinical Obstetrics & Gynaecology
|August 19, 2014
Summary
Desquamative inflammatory vaginitis (DIV) is a rare chronic vaginal inflammation primarily affecting Caucasian women during perimenopause. Treatment with anti-inflammatory agents like vaginal clindamycin or corticosteroids is effective, though relapses are common.
Area of Science:
- Gynecology
- Vaginal Health
Background:
- Desquamative inflammatory vaginitis (DIV) is an uncommon, chronic purulent vaginitis.
- It predominantly affects Caucasian women, particularly during perimenopause.
- DIV is a diagnosis of exclusion, requiring differentiation from other causes of purulent vaginitis.
Purpose of the Study:
- To summarize the characteristics, diagnosis, and management of desquamative inflammatory vaginitis (DIV).
Main Methods:
- Review of clinical presentation, diagnostic criteria, and treatment options for DIV.
- Microscopic examination of vaginal secretions revealing increased inflammatory and parabasal cells.
- Vaginal pH is consistently elevated above 4.5.
Main Results:
- Key symptoms include purulent discharge, vestibulo-vaginal irritation, and dyspareunia.
- Physical examination may show erythema and petechiae on vaginal walls.
- Microscopy confirms increased inflammatory cells and parabasal cells, with abnormal vaginal flora.
Conclusions:
- The etiology of DIV is unknown but likely immune-mediated, suggested by response to anti-inflammatory agents.
- Treatment options include local vaginal clindamycin or corticosteroids.
- Due to its chronic nature and common relapses, maintenance therapy should be considered.
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