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Vol. 99. Issue 3.
Pages 190-198 (April 2008)
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Vol. 99. Issue 3.
Pages 190-198 (April 2008)
Practical dermatology
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Recurrent Vulvovaginitis: Diagnostic Assessment and Therapeutic Management
Vulvovaginitis de Repetición. Valoración Diagnóstica y Manejo Terapéutico
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A. Ramírez-Santos, M. Pereiro Jr
Corresponding author
manuelpe@usc.es

Correspondence: Departamento de Dermatología, Facultad de Medicina, San Francisco s/n, 15782 Santiago de Compostela, La Coruña, Spain.
, J. Toribio
Departamento de Dermatología, Complejo Hospitalario Universitario, Facultad de Medicina, Santiago de Compostela, La Coruña, Spain
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Abstract

Recurrent vulvovaginitis is a common problem in clinical practice. Management is often complicated by a long history of inappropriate treatments based on tentative diagnoses after an incomplete diagnostic workup. We review the most common causes of recurrent vulvovaginitis; the appropriate steps with which to establish a diagnosis, from the medical history through to the additional tests needed; and, finally, the best therapeutic options. We will focus on infectious, irritant, allergic, and hormonal causes as the ones of most interest to the dermatologist. Given that infection is the most frequent cause of these processes and also a common reason for inopportune treatment, we will pay particular attention to infectious etiologies and their differential diagnosis.

Key words:
vulvovaginal candidosis
Trichomonas
bacterial vaginosis
allergic vulvovaginitis
Resumen

Las vulvovaginitis de repetición son un problema común en la práctica clínica. El manejo de estas pacientes se complica a menudo con una larga anamnesis de tratamientos tan tentativos como inadecuados, ya que parten a menudo de un procedimiento diagnóstico incompleto. En este artículo revisamos las causas más frecuentes de estos cuadros, los pasos adecuados para establecer su diagnóstico, desde la anamnesis hasta las pruebas complementarias necesarias, y por último, las medidas terapéuticas oportunas. Nos centramos, por ser de mayor interés para el dermatólogo, en las de causa infecciosa, irritativa, alérgica y hormonal. Prestamos especial atención a los cuadros de etiología infecciosa y a su diagnóstico diferencial, por ser la causa más común de estos procesos y también frecuente motivo de tratamientos intempestivos.

Palabras clave:
vulvovaginitis candidiásica
Trichomona
vaginosis bacterianas
vulvovaginitis alérgica
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