title: Prognosis and treatment of desquamative inflammatory vaginitis.
abstract: OBJECTIVE
  Desquamative inflammatory vaginitis is a clinical syndrome frequently unrecognized, characterized by vaginal rash and purulent discharge. We describe patient outcomes and treatment at follow-up in a case series of 98 women diagnosed with this syndrome.
  
  
  METHODS
  We performed a chart review of 130 patients diagnosed with desquamative inflammatory vaginitis between 1996 and 2007 in a referral university-based vaginitis clinic. Clinical findings, laboratory findings, and treatment were documented during the first 12 months and at 2 and 4 years.
  
  
  RESULTS
  Of the 98 patients reviewed, 97 were white; mean age was 48.6 years (plus or minus 10.2 years), and 50% were postmenopausal. All patients were symptomatic with vaginal inflammation and 72% had vestibular findings. Treatment with topical 2% clindamycin (54%) or 10% hydrocortisone (46%) dramatically relieved symptoms within 3 weeks (median) in 86% of patients. Treatment was discontinued (median 8 weeks) in 53 patients experiencing clinical remission accompanied by normal wet mount appearance; however, 17 (32%) relapsed within 6 weeks. At 1 year, cure was achieved in 25 patients (26%), 57 (58%) were asymptomatic but remained dependent on maintenance treatment, and 16 (16%) were partially controlled only. A favorable initial response to therapy was associated with positive clinical prognosis by 20 weeks of follow-up (P=.01).
  
  
  CONCLUSIONS
  Desquamative inflammatory vaginitis is a chronic inflammatory process involving both vagina and vestibule, occurring almost exclusively in white women, that responds well to topical anti-inflammatory therapy, although long-term maintenance therapy frequently is required.
  
  
  METHODS
  III.
authors.affiliation: From the Division of Infectious Diseases, Department of Medicine, and the Department of Family Medicine, Wayne State University School of Medicine, Detroit, Michigan.
authors.forename: Jack D
authors.initials: JD
authors.lastname: Sobel
authors.forename: Orna
authors.initials: O
authors.lastname: Reichman
authors.forename: Dawn
authors.initials: D
authors.lastname: Misra
authors.forename: Wonsuk
authors.initials: W
authors.lastname: Yoo
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000367:Age Factors; D002981:Clindamycin / Q000627:therapeutic use*; D015331:Cohort Studies; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use*; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014848:Vulvovaginitis / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology*
chemical_list: D002981:Clindamycin; D006854:Hydrocortisone