Desquamative Inflammatory Vaginitis
Marisa R. Nucci, MD
Key Facts
Terminology
Inflammatory vaginitis with marked inflammation and sloughing of epithelium
Etiology/Pathogenesis
Unknown, may be autoimmune or may represent form of erosive lichen planus
Clinical Issues
Most commonly affects white women > 50 years
Dyspareunia, postcoital bleeding, and purulent vaginal discharge
Localized or diffuse erythema
Majority require treatment > 1 year
Microscopic Pathology
Dense acute and chronic inflammatory infiltrate
Thinning &/or desquamation of squamous epithelium
 Desquamative inflammatory vaginitis usually appears as erythematous areas of the vaginal mucosa, either focal or diffuse (as pictured). (Courtesy H. Haefner, MD.) |
 The epithelium adjacent to desquamative inflammatory vaginitis is often attenuated and atrophic. Note the intense mixed inflammatory infiltrate. |
TERMINOLOGY
Abbreviations
Desquamative inflammatory vaginitis (DIV)
Definitions
Vaginitis of uncertain etiology characterized by marked inflammatory infiltrate and sloughing of epithelium
ETIOLOGY/PATHOGENESIS
Unknown Etiology
May be a form of erosive lichen planus
Can coexist with gingival mucositis
Possibly an autoimmune disorder
Responds to anti-inflammatory agents
CLINICAL ISSUES
Epidemiology
Incidence
Rare
Age
Most common in 5th decade
50% postmenopausal
Ethnicity
White women affected more than other ethnic groups
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