Value of colposcopy in the diagnosis of candidiasis in patients with vulvodynia.
OBJECTIVE
To evaluate the value of colposcopy in the diagnosis of chronic vulvar candidiasis in patients presenting with vulvodynia.


METHODS
A prospective study of 460 patients presenting with vulvodynia over a 24-month period was undertaken. All patients underwent colposcopy of the vulva, which was regarded as positive if acetowhite lesions with central clearing with or without petechiae were present. Vulvar skin scrapings were taken for Candida culture on all patients. Those patients with positive colposcopic findings were treated with long-term oral antimycotic therapy irrespective of laboratory findings.


RESULTS
Patients with positive colposcopic findings and positive cultures had a 93% rate of improvement in symptoms. Those with positive colposcopic findings and negative cultures also had a 60% rate of improvement. Thus, the overall improvement rate in patients with positive colposcopic findings (irrespective of culture results) was 76%. When colposcopy findings were negative, Candida cultures were also negative in 92% of patients.


CONCLUSIONS
Colposcopy of the vulva can be a valuable triage tool in the assessment of patients with vulvodynia by detecting changes that are highly suspicious for the presence of chronic vulvar candidiasis.
Pagano
Ross
R
Vulvar Disorders Clinic, Royal Women's Hospital, Carlton, Melbourne, Australia. paganor@ramsayhealth.com.au
D000293:Adolescent; D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D002177:Candidiasis / Q000175:diagnosis* / Q000188:drug therapy; D003127:Colposcopy; D005260:Female; D015725:Fluconazole / Q000627:therapeutic use; D006801:Humans; D007654:Ketoconazole / Q000627:therapeutic use; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis*; D014845:Vulvar Diseases / Q000175:diagnosis* / Q000382:microbiology* / Q000473:pathology
D000935:Antifungal Agents; D015725:Fluconazole; D007654:Ketoconazole