From the Research
Desquamative inflammatory vaginitis (DIV) should be treated with clindamycin 2% vaginal cream applied once daily for 14 days, followed by maintenance therapy 2-3 times weekly for 4-6 weeks, as this regimen has been shown to dramatically relieve symptoms in 86% of patients within 3 weeks, as reported in the study by 1.
Treatment Overview
The treatment of DIV typically involves the use of topical anti-inflammatory agents, such as clindamycin or hydrocortisone, to reduce inflammation and alleviate symptoms.
- Clindamycin 2% vaginal cream is a commonly recommended treatment option, applied once daily for 14 days, followed by maintenance therapy 2-3 times weekly for 4-6 weeks.
- Alternatively, 2% intravaginal hydrocortisone can be used with the same regimen, as both medications have been shown to be effective in treating DIV, as noted in the study by 2.
- For severe cases, a combination of both medications may be necessary, as suggested by the study by 1.
Diagnostic Considerations
Before starting treatment, it is essential to confirm the diagnosis of DIV through vaginal pH and microscopy, as DIV typically presents with a pH >4.5 and increased parabasal cells with neutrophils on wet mount, as reported in the study by 3.
- Patients should be advised to avoid sexual intercourse during treatment or use condoms, and to complete the full course even if symptoms improve quickly.
- Treatment success is indicated by resolution of symptoms (discharge, burning, irritation) and normalization of vaginal flora on follow-up examination.
Recurrence and Maintenance Therapy
Recurrence is common in DIV, so patients should be monitored and may require intermittent maintenance therapy, as noted in the study by 4.