Prognosis and treatment of desquamative inflammatory vaginitis

Jack D. Sobel, Orna Reichman, Dawn Misra, Wonsuk Yoo

Research output: Contribution to journalArticle

35 Citations (Scopus)

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). Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)850-855
Number of pages6
JournalObstetrics and Gynecology
Volume117
Issue number4
DOIs
StatePublished - Apr 1 2011

Fingerprint

Vaginitis
Therapeutics
Clindamycin
Vagina
Exanthema
Hydrocortisone
Anti-Inflammatory Agents
Referral and Consultation
Inflammation

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

Prognosis and treatment of desquamative inflammatory vaginitis. / Sobel, Jack D.; Reichman, Orna; Misra, Dawn; Yoo, Wonsuk.

In: Obstetrics and Gynecology, Vol. 117, No. 4, 01.04.2011, p. 850-855.

Research output: Contribution to journalArticle

Sobel, Jack D. ; Reichman, Orna ; Misra, Dawn ; Yoo, Wonsuk. / Prognosis and treatment of desquamative inflammatory vaginitis. In: Obstetrics and Gynecology. 2011 ; Vol. 117, No. 4. pp. 850-855.
@article{a283ed1d024840d185c9079b71cefb58,
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). Conclusion: 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.",
author = "Sobel, {Jack D.} and Orna Reichman and Dawn Misra and Wonsuk Yoo",
year = "2011",
month = "4",
day = "1",
doi = "10.1097/AOG.0b013e3182117c9e",
language = "English (US)",
volume = "117",
pages = "850--855",
journal = "Obstetrics and Gynecology",
issn = "0029-7844",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Prognosis and treatment of desquamative inflammatory vaginitis

AU - Sobel, Jack D.

AU - Reichman, Orna

AU - Misra, Dawn

AU - Yoo, Wonsuk

PY - 2011/4/1

Y1 - 2011/4/1

N2 - 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). Conclusion: 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.

AB - 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). Conclusion: 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.

UR - http://www.scopus.com/inward/record.url?scp=79953173979&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=79953173979&partnerID=8YFLogxK

U2 - 10.1097/AOG.0b013e3182117c9e

DO - 10.1097/AOG.0b013e3182117c9e

M3 - Article

VL - 117

SP - 850

EP - 855

JO - Obstetrics and Gynecology

JF - Obstetrics and Gynecology

SN - 0029-7844

IS - 4

ER -