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Management of Chronic Recurrent Vulvovaginitis

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Handbook of Gynecology

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Abstract

Vulvovaginitis is the most common reason why women present to a gynecologist. The term covers inflammation or infection of the vagina and/or vulva. Women with symptoms lasting for more than 6 months experience chronic vulvovaginitis. The clinical presentation of women with vulvovaginitis is similar regardless of the underlying cause and so a careful history is important. Symptoms include itching, discharge, irritation, dysuria, vaginal odor, rash, and burning. Other findings on exam include erythema, edema and excoriation of the vulvar skin, ulceration, or chronic vulvar skin changes. The following investigations can aid diagnosis: vaginal pH, amine whiff test, vulvar biopsy, fungal cultures, and wet smears. Causes fall into four main groups, infections, dermatoses, atrophy, and neoplasia. Infectious causes include bacterial vaginosis, vulvovaginal candidiasis, Trichomonas vaginalis, and threadworms (pinworms). Symptoms will improve following effective treatment of the infection. Vaginal atrophy is a result of estrogen deficiency and is improved with estrogen replacement. Dermatoses include lichen sclerosus, lichen planus, contact dermatitis, and lichen simplex. Treatment of dermatoses includes steroids, topical estrogens, tacrolimus ointment, retinoids, and emollients. All women will benefit from good vulvar skin care and emotional support.

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Authors and Affiliations

  1. Great Western Hospitals NHS Foundation Trust, Swindon, UK

    Abigail Kingston & Emma Torbé

Authors
  1. Abigail Kingston
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  2. Emma Torbé
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Correspondence to Abigail Kingston .

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Editors and Affiliations

  1. Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA

    Donna Shoupe

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Kingston, A., Torbé, E. (2023). Management of Chronic Recurrent Vulvovaginitis. In: Shoupe, D. (eds) Handbook of Gynecology. Springer, Cham. https://doi.org/10.1007/978-3-031-14881-1_26

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  • DOI: https://doi.org/10.1007/978-3-031-14881-1_26

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-031-14880-4

  • Online ISBN: 978-3-031-14881-1

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