Coping with chronic vulvovaginal candidiasis

33 Key points • Vulvovaginal candidiasis (VVC) covers a disease spectrum, from a single episode to chronic disease with unremitting symptoms. • The concept of chronic VVC was recently described; it is a common cause of chronic nonerosive vulvo vaginitis in women present ing at vulval disease clinics. • Evidence suggests chronic VVC is a hyper sensitivity response to commensal Candida spp. • In healthy non-diabetic patients, chronic VVC, like acute VVC, occurs only in the presence of oestrogen. • Chronic VVC may be diagnosed based on clinical features and a history that satisfies specific criteria; diagnosis is supported by, but does not require, a positive swab result for Candida spp. at presentation. • Patients with chronic VVC respond well to oral antifungal therapy, which may be needed long term. MedicineToday 2014; 15(2): 33-40