ABSTRACT
BACKGROUND Desquamative inflammatory vaginitis (DIV) is a clinical malady that is usually not recognized by doctors responsible for the care of these symptomatic, distressed patients. There are many reasons for this. It is an uncommon condition even for savvy infectious disease experts who have a referral practice filled with patients who have chronic vulvovaginal problems that have not responded to the care of their primary physicians. In this referral practice setting, Sobel found 51 patients with DIV among 7,000 (0.73%) patients seen over a 7-year period1. This disease mimics other inflammatory vulvovaginal infections that are much more commonly seen. These patients have gross and microscopic vaginal inflammation that is associated in the minds of most practitioners with Trichomonas vaginitis. DIV can also be confused with menopausal vulvovaginitis for it is more commonly seen in older women who have a paucity of mature vaginal squamous cells seen on microscopic examination of the saline preparation. This is a condition that Donders, an esteemed European investigator of vaginitis, would characterize as distinct from bacterial vaginosis (BV) and that he has named aerobic vaginitis2.
