title: Relationship between infectious agents for vulvovaginitis and skin color.
abstract: OBJECTIVE
  Many factors influence occurrences of vulvovaginitis. The aims here were to assess skin color and age-related differences in the vaginal flora and occurrences of vulvovaginitis.
  
  
  METHODS
  Cross-sectional study; tertiary referral hospital (Universidade Federal do Triângulo Mineiro, Uberaba).
  
  
  METHODS
  Healthy women who underwent routine outpatient gynecological assessments were assessed for vulvovaginitis and vaginal flora and then divided into whites (n = 13,881) and nonwhites (n = 5,295). Statistical analysis was performed using the X² test, logistic regression and odds ratios.
  
  
  RESULTS
  The vaginal microflora was skin-color dependent, with greater occurrence of clue cells, Trichomonas vaginalis and coccobacilli in nonwhite women (p < 0.0001). Döderlein bacilli and cytolytic flora were more prevalent in white women (p < 0.0001 and p < 0.05, respectively). The vaginal microflora was age-dependent within the skin color groups. Among the nonwhite women, clue cells were more prevalent in women aged 21 to 50 years; Trichomonas in women up to 40 years and coccobacili in women between 21 and 40 years (P < 0.05). During the proliferative and secretory phases, the nonwhite women were more likely to present clue cells, Trichomonas, Candida and coccobacilli (OR, proliferative phase: 1.31, 1.79, 1.6 and 1.25 respectively; secretory phase: 1.31, 2.88, 1.74 and 1.21 respectively), while less likely to present Döderlein flora (OR, proliferative phase: 0.76; secretory phase: 0.66), compared with white women, irrespective of age.
  
  
  CONCLUSIONS
  There are differences in vulvovaginitis occurrence relating to skin color, which may be associated with variations in vaginal flora.
authors.affiliation: Instituto de Pesquisa em Oncologia, Discipline of Gynecology and Obstetrics, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil. rosekeila@terra.com.br
authors.forename: Rosekeila Simoes
authors.initials: RS
authors.lastname: Nomelini
authors.forename: Ana Paula Borges
authors.initials: AP
authors.lastname: Carrijo
authors.forename: Sheila Jorge
authors.initials: SJ
authors.lastname: Adad
authors.forename: Altacílio Aparecido
authors.initials: AA
authors.lastname: Nunes
authors.forename: Eddie Fernando Candido
authors.initials: EF
authors.lastname: Murta
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002175:Candida / Q000302:isolation & purification*; D004812:Epidemiologic Methods; D005260:Female; D006090:Gram-Negative Bacteria / Q000302:isolation & purification*; D006801:Humans; D008597:Menstrual Cycle / Q000502:physiology; D008875:Middle Aged; D012880:Skin Pigmentation; D014246:Trichomonas vaginalis / Q000302:isolation & purification*; D014621:Vagina / Q000382:microbiology*; D014848:Vulvovaginitis / Q000453:epidemiology / Q000382:microbiology*; D055815:Young Adult