Current Infectious Disease Reports

, Volume 12, Issue 6, pp 479–483 | Cite as

Clinical Spectrum of Desquamative Inflammatory Vaginitis

Article

Abstract

Desquamative inflammatory vaginitis (DIV) is a rare chronic clinical syndrome of unknown etiology characterized by profuse purulent vaginal discharge, diffuse exudative vaginitis, epithelial cell exfoliation, and pain. A diagnosis of DIV is often missed by even experienced practitioners owing to its rarity and its clinical and laboratory presentation similar to other inflammatory vulvovaginal disorders. Although DIV is difficult to treat and often requires long-term therapy for maintenance, successful therapy has been reported with topical steroids and clindamycin.

Keywords

Desquamative Inflammatory Vaginitis Vaginal discharge Vaginal disease 

Notes

Disclosure

No potential conflict of interest relevant to this article was reported.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. 1.
    Nyirjesy P, Peyton C, Weitz MV, et al.: Causes of chronic vaginitis. Obstet Gynecol 2006, 108:1185–1191.PubMedGoogle Scholar
  2. 2.
    Scheffey LC, Rakoff AE, Lang WR: An unusual case of exudative vaginitis (hydrorrhea vaginalis) treated with local hydrocortisone. Am J Obstet Gynecol 1956, 72:208–211.PubMedGoogle Scholar
  3. 3.
    Gray LA, Barnes ML: Vaginitis in women, diagnosis and treatment. Am J Obstet Gynecol 1965, 92:125–127.PubMedGoogle Scholar
  4. 4.
    Gardner HL: Desquamative inflammatory vaginitis: a newly defined entity. Am J Obstet Gynecol 1968, 102:1102–1105.PubMedGoogle Scholar
  5. 5.
    Lynch P: Desquamative inflammatory vaginitis with oral lichen planus. Presented at the Second International Congress of the International Society for the Study of Vulvar Disease. Key Biscayne, Florida: January 9–11, 1975.Google Scholar
  6. 6.
    Edwards L, Friedrich EG: Desquamative vaginitis: lichen planus in disguise. Obstet Gynecol 1988, 71:832–836.PubMedGoogle Scholar
  7. 7.
    Oates JD, Rowen D: Desquamative inflammatory vaginitis. A review. Genitourin Med 1990, 66:275–279.PubMedGoogle Scholar
  8. 8.
    Sobel JD: Desquamative inflammatory vaginitis: a new subgroup of purulent vaginitis responsive to topical 2% clindamycin therapy. Am J Obstet Gynecol 1994, 171:1215–1220.PubMedGoogle Scholar
  9. 9.
    Peacocke M, Djurkinak E, Thys-Jacobs S: Treatment of desquamative inflammatory vaginitis with vitamin D: A case report. Cutis 2008, 81:75–78.PubMedGoogle Scholar
  10. 10.
    Edwards L: Desquamative inflammatory vaginitis. In Genital Dermatology Atlas. Edited by Edwards L. Philadelphia: Lippincott Williams & Wilkins; 2004:237–240.Google Scholar
  11. 11.
    Ledger WJ, Witkin SS: Desquamative inflammatory vaginitis. In Vulvovaginal Infections. Edited by Ledger WJ, Witkin SS. London: Manson Publishing; 2007:49–52.Google Scholar
  12. 12.
    Lev-Sagie A, Nyirjesy P: Treatment of desquamative inflammatory vaginitis (DIV) with intravaginal 2% clindamycin cream: a long term follow-up. J Low Genit Tract Dis 2009, 13(5 Suppl):S2.Google Scholar
  13. 13.
    Murphy R: Desquamative inflammatory vaginitis. Dermatol Ther 2004, 17:47–49.CrossRefPubMedGoogle Scholar
  14. 14.
    Paavonen J: Desquamative inflammatory vaginitis. Infect Dis Obstet Gynecol 1996, 4:257.CrossRefPubMedGoogle Scholar
  15. 15.
    • Murphy R, Edwards L: Desquamative inflammatory vaginitis, what is it? J Reprod Med 2008, 53:124–128. The authors report the histopathology findings of idiopathic DIV. PubMedGoogle Scholar
  16. 16.
    Nyirjesy P: Postmenopausal vaginitis. Curr Infect Dis Rep 2007, 9:480–484.CrossRefGoogle Scholar
  17. 17.
    Newbern EC, Foxman B, Leaman D, Sobel JD: Desquamative inflammatory vaginitis: an exploratory case-control study. Ann Epidemiol 2002, 12:346–352.CrossRefPubMedGoogle Scholar
  18. 18.
    • Reichman R, Sobel JD: Desquamative inflammatory vaginitis (DIV): twelve year experience with one hundred and thirty patients—new insights. J Low Genit Tract Dis 2009, 13(5 Suppl):S2. The authors presented preliminary findings on the largest cohort of women with DIV. Google Scholar
  19. 19.
    Fowler RS: Expansion of altered vaginal flora states in vaginitis to include a spectrum of microflora. J Reprod Med 2007, 52:93–99.PubMedGoogle Scholar
  20. 20.
    Donders GGG, Vereecken A, Bosmans E, et al.: Definition of a type of abnormal vaginal flora that is distince from bacterial vaginosis: aerobic vaginitis. BJOG 2002, 109:34–43.CrossRefPubMedGoogle Scholar
  21. 21.
    Dennerstein G, Scurry J, Brenan J, et al: Desquamative inflammatory vaginitis. In The Vulva and Vagina Manual. Edited by Dennerstein G, Scurry J, Brenan J, et al. Australia: Gynederm Publishing; 2005:170–172.Google Scholar
  22. 22.
    Jacobson M, Krumholz B, Franks A: Desquamative inflammatory vaginitis. J Reprod Med 1989, 34(9):647–650.PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyUniversity of IowaIowa CityUSA

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