In The V Book, Stewart (2002) calls DIV (Desquamative Inflammatory Vaginitis) the "mystery vaginitis." She could just as well be referencing the difficulty patients have in obtaining a diagnosis ("you are a mystery patient!") as she could be referencing its unknown cause.
The symptoms of DIV are:
The cause is unknown. While it is possible that it is caused by an unknown bacterial cause, it is most likely an auto-immune disorder, and there may possibly be a link to lichen planus (which is also auto-immunie in nature). A lack of estrogen may also play a role.
Clindamycin is an antibiotic that is also anti-inflammatory. Sobel (1994) published a study in which >95% of women treated with clindamycin resulted in clinical improvement (although 30% relapsed). As a result, he hypothesized an unknown bacterial agent as a cause of DIV. Stewart (2002) reports limited success with Clindamycin. Mechcatie (2005) says that DIV is not caused by infection; the anti-inflammatory properties of Clindamycin are the reason it is used as a treatment.
Hydrocortisone and Estrogen
Hydrocortisone suppositories are the other common form of treatment, and estrogen may be added to the hydrocortisone suppositories. The Centers for Vulvovaginal Disorders describe success with a "shot-gun" approach of suppositories that include hydrocortisone, clindamycin, and estrogen.
There is limited research that suggests that low levels of vitamin D could cause DIV and that supplementing with vitamin D can reduce symptoms. You can skip on over to my previous blog post on vitamin D to read more.
Drexel Medicine "About Desquamative Inflammatory Vaginitis"
The V Book, by Elizabeth Stewart (2002)
"Desquamative inflammatory vaginitis: a new subgroup of purulent vaginitis responsive to topical 2% clindamycin therapy." by JD Sobel in The American Journal of Obstetric Gynecology 1994 Nov;171(5):1215-20.
OHSU Center for Women's Health "Desquamative Inflammatory Vaginitis"
"Desquamative Vaginitis: Not an Infectious Entity : Condition may be a range of blistering disorders; as such, no one treatment is always appropriate." by Elizabeth Mechcatie in Hospitalist News, September 1, 2005
The Centers for Vulvovaginal Disorders "Desquamative Inflammatory Vaginitis"
I have DIV, vulvodynia, and vaginismus. When I have low moments, I often wish for some kind of community of support. For that reason, I have created this blog. I have some posts here about my own experiences, but what I'm really hoping to do is post stories from other women (from YOU!); your story of your diagnosis, your treatment, and your life with DIV (and/or vulvodynia, vaginismus, lichen planus, etc.). If you would like to share your story, please hop on over to my contact form on the home page and send me a note.