Desquamative inflammatory vaginitis: The unknown

Abstract

Introduction: Desquamative inflammatory vaginitis (DIV) is a chronic inflammatory process of unknown etiology, characterized by genital pain and profuse vaginal discharge, mainly affecting perimenopausal women. It is an entity little known by clinicians, leading to a delay in diagnosis and the consequent alteration of the patients’ quality of life. The aim in this manuscript is to analyze DIV through the review of a case and the scientific literature.  Case presentation: We report the case of a 40-year-old woman who presented this clinical profile for several years, being misdiagnosed as more common syndromes such as infectious vaginitis and vaginismus. Finally, after the diagnosis of DIV and the establishment of the specific treatment, she showed a clear symptomatic improvement. Conclusion: The prevalence of DIV is unknown and underestimated, and may affect 8% of women with vulvovaginal symptoms. To reach the correct diagnosis, it is required to observe a few simple clinical and laboratory criteria defined by Sobel in 1994. It responds to the topical therapy with clindamycin or hydrocortisone in 95% of cases, but in most cases a long-term maintenance therapy is necessary to control the symptoms.