title: Desquamative inflammatory vaginitis.
abstract: Desquamative inflammatory vaginitis (DIV) is an uncommon form of chronic purulent vaginitis. It occurs mainly in Caucasians with a peak occurrence in the perimenopause. Symptoms and signs are nonspecific; DIV is a diagnosis of exclusion, and other causes of purulent vaginitis should be excluded. The main symptoms include purulent discharge, vestibulo-vaginal irritation, and dyspareunia. Examination of vaginal walls shows signs of inflammation with increased erythema and petechiae. Through microscopy (wet mount) of the vaginal secretions, DIV is defined by an increase in inflammatory cells and parabasal epithelial cells (immature squamous cells). Vaginal flora is abnormal and pH is always elevated above 4.5. Although etiology and pathogenesis remain unknown, the favorable response to anti-inflammatory agents suggests that the etiology is immune mediated. Either local vaginal clindamycin or vaginal corticosteroids are adequate treatment. As a chronic condition, maintenance treatment should be considered as relapse is common.
authors.affiliation: Dept. of Obstetric and Gynecology, Shaare Zedek medical Center, Hebrew University, Jerusalem, Israel. Electronic address: Orna.reich@gmail.com.
authors.forename: Orna
authors.initials: O
authors.lastname: Reichman
authors.affiliation: Division of Infectious Diseases, Detroit Medical Center, 3990 John R - 5 Hudson, Detroit, MI 48201, USA. Electronic address: jsobel@med.wayne.edu.
authors.forename: Jack
authors.initials: J
authors.lastname: Sobel
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002981:Clindamycin / Q000627:therapeutic use; D003937:Diagnosis, Differential; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D014621:Vagina / Q000473:pathology*; D014627:Vaginitis / Q000175:diagnosis* / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D005938:Glucocorticoids; D002981:Clindamycin
keywords: desquamative inflammatory vaginitis; purulent vaginitis