Correspondence

Acute Vulvovaginitis

N Engl J Med 2006; 355:2791December 28, 2006

Article

To the Editor:

In her review of vulvovaginitis (Sept. 21 issue),1 Dr. Eckert does not discuss various noninfectious causes of symptoms that warrant consideration. Many women with maceration-related vulvitis have a recent history of receiving various therapies for vaginitis, often prescribed over the telephone by an office nurse for reported vaginal infection, to no avail. This maceration is associated with tight clothing, impermeable sanitary pads, and panty hose (thus the name “panty hose vulvitis”). Pruritus is the major problem and often involves the perianal skin as well as the vulva. The use of loose clothing, tissue placed against the moist skin, and topical cortisone quickly reverses this problem.

Robert L. Shirley, M.D.
Brigham and Women's Hospital, Boston, MA 02115
bobdoc@massmed.org

1 References

1
Eckert LO. Acute vulvovaginitis. N Engl J Med 2006;355:1244-1252
Full Text | Web of Science | Medline

Author/Editor Response

My article focused on infectious causes of vulvovaginitis. I appreciate Dr. Shirley's reminder that there may be noninfectious causes of vulvitis, such as tight clothing, panty hose, and impermeable sanitary pads. Other causes include the use of soaps on the vulva, laundry detergents (specifically those containing bleach), fabric softeners, and washcloths — to name just a few.

Linda O. Eckert, M.D.
University of Washington, Seattle, WA 98104
eckert@u.washington.edu

Citing Articles (1)