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. 2010 Dec;128(6):348-53.
doi: 10.1590/s1516-31802010000600007.

Relationship between infectious agents for vulvovaginitis and skin color

Rosekeila Simoes Nomelini  1 , Ana Paula Borges Carrijo, Sheila Jorge Adad, Altacílio Aparecido Nunes, Eddie Fernando Candido Murta
Affiliations

Relationship between infectious agents for vulvovaginitis and skin color

Rosekeila Simoes Nomelini et al. Sao Paulo Med J. 2010 Dec.

Abstract
in English, Portuguese

Context and objective: Many factors influence occurrences of vulvovaginitis. The aims here were to assess skin color and age-related differences in the vaginal flora and occurrences of vulvovaginitis.

Design and setting: Cross-sectional study; tertiary referral hospital (Universidade Federal do Triângulo Mineiro, Uberaba).

Methods: Healthy women who underwent routine outpatient gynecological assessments were assessed for vulvovaginitis and vaginal flora and then divided into whites (n = 13,881) and nonwhites (n = 5,295). Statistical analysis was performed using the X² test, logistic regression and odds ratios.

Results: The vaginal microflora was skin-color dependent, with greater occurrence of clue cells, Trichomonas vaginalis and coccobacilli in nonwhite women (p < 0.0001). Döderlein bacilli and cytolytic flora were more prevalent in white women (p < 0.0001 and p < 0.05, respectively). The vaginal microflora was age-dependent within the skin color groups. Among the nonwhite women, clue cells were more prevalent in women aged 21 to 50 years; Trichomonas in women up to 40 years and coccobacili in women between 21 and 40 years (P < 0.05). During the proliferative and secretory phases, the nonwhite women were more likely to present clue cells, Trichomonas, Candida and coccobacilli (OR, proliferative phase: 1.31, 1.79, 1.6 and 1.25 respectively; secretory phase: 1.31, 2.88, 1.74 and 1.21 respectively), while less likely to present Döderlein flora (OR, proliferative phase: 0.76; secretory phase: 0.66), compared with white women, irrespective of age.

Conclusions: There are differences in vulvovaginitis occurrence relating to skin color, which may be associated with variations in vaginal flora.

CONTEXTO E OBJETIVO:: Muitos fatores influenciam a ocorrência de vulvovaginites. Os objetivos foram avaliar diferenças relacionadas à cor da pele e idade na flora vaginal e vulvovaginites.

TIPO DE ESTUDO E LOCAL:: Estudo transversal; hospital de referência terciário (Universidade Federal do Triângulo Mineiro, Uberaba).

MÉTODOS:: Mulheres saudáveis em atendimento de rotina para exames ginecológicos foram divididas em brancas (n = 13.881) e não brancas (n = 5.295) e avaliadas quanto a vulvovaginites e flora vaginal. Para análise estatística, foram utilizados teste X2, regressão logística e odds ratio.

RESULTADOS:: Microflora vaginal foi dependente da cor da pele, com maior ocorrência de “clue cells”, Trichomonas vaginalis e bacilos cocoides em não brancas (P < 0,0001); bacilos de Döderlein e flora citolítica foram mais prevalentes em brancas (P < 0,0001 e P < 0,05, respectivamente). Flora vaginal foi dependente da idade nos grupos de cor da pele. Entre não brancas, “clue cells”, Trichomonas e bacilos cocoides foram mais prevalentes nas idades: 21 a 50 anos, até 40 anos, e 21 a 40 anos respectivamente (P < 0,05). Durante as fases proliferativa e secretória, mulheres não brancas tiveram maior probabilidade de apresentar “clue cells”, Trichomonas, Candida e cocoides (odds ratio, OR - fase proliferativa: 1,31; 1,79; 1,6 e 1,25 respectivamente; fase secretória: 1,31; 2,88; 1,74 e 1,21 respectivamente), e menor chance de apresentarem flora Döderlein (OR - fase proliferativa: 0,76; fase secretória: 0,66) comparadas com brancas, independentemente da idade.

CONCLUSÕES:: Há diferenças na ocorrência de vulvovaginites relacionadas com a cor da pele, podendo haver associação com variações na flora vaginal.

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Conflict of interest statement

Conflict of interest: None

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