• Rosekeila Simoes Nomelini, Ana Paula Borges Carrijo, Sheila Jorge Adad, Altacílio Aparecido Nunes, and MurtaEddie Fernando CandidoEF.
• Instituto de Pesquisa em Oncologia, Discipline of Gynecology and Obstetrics, Universidade Federal do Triângulo Mineiro, Uberaba, Minas Gerais, Brazil. rosekeila@terra.com.br
• Sao Paulo Med J. 2010 Dec 1; 128 (6): 348353348-53.

Context And ObjectiveMany 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 SettingCross-sectional study; tertiary referral hospital (Universidade Federal do Triângulo Mineiro, Uberaba).MethodsHealthy 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.ResultsThe 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.ConclusionsThere are differences in vulvovaginitis occurrence relating to skin color, which may be associated with variations in vaginal flora.

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