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Non-infectious desquamative inflammatory vaginitis
Last reviewed: 23.04.2024
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Non-infectious desquamative inflammatory vaginitis - inflammation of the vagina in the absence of the usual infectious causes of the disease. The disease can be of an autoimmune nature. On the cells of the surface layer of the vaginal epithelium, streptococci are adsorbed. The main risk factors are a decrease in the level of estrogen that occurs during the menopause, or a decrease in ovarian functions (for example, due to ovarian removal, pelvic irradiation or chemotherapy). Atrophy of the genital organs predisposes to inflammatory vaginitis and increases the risk of recurrence of the disease.
[Symptoms of vaginitis
Common symptoms of the disease are purulent discharge from the vagina, dyspareunia, dysuria and irritation of the mucous membrane of the vagina. There are also itching in the vagina, hyperemia, sometimes burning, pain or mild bleeding. There is dryness in the vagina and exhaustion of the mucous membrane. Vaginitis can recur.
Because the symptoms of vaginitis may be common with other forms of vaginitis, differential diagnosis (pH of the vaginal secretion, microscopic examination, amine test) should be performed. The diagnosis is made if the pH of the vaginal secretion is more than 6, the amine test is negative, and with leukemia microscopy, leukocytes and parabasal cells are detected.
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Treatment of vaginitis
The vaginal cream of clindamycin is prescribed for 5 g every evening for 1 week. After treatment with clindamycin, women should be screened for atrophy, as this increases the risk of recurrence. When atrophy, the appointment of estrogens for topical application (for example, 0.01% vaginal cream of estradiol 24 g once a day for 1-2 weeks, then 1-2 g once a day for 1-2 weeks, then 1 g 1 -3 times a week, vaginal pills of estradiol hemihydrate 25 mcg 2 times a week, estradiol rings every 3 months). Preference is given to treatment with drugs for topical use as more safe than oral hormone therapy (hormone replacement therapy).