Mycosis fungoides is a common disease, and the standard medical diagnosis has now been revised to “vulvovaginal candidiasis”, or VVC for short, or Candida vaginitis for short.
It is common because about 75% of women have at least one episode in their lifetime, while 40-50% have more than 2 episodes, and a small percentage of 5-8% may have more than 4 episodes a year, and the last part can be diagnosed as recurrent vaginal pseudomonal yeast disease, or RVVC. VVC.
The main manifestations of VVC are increased vaginal discharge, vaginal itching, frequent urination, painful urination and painful intercourse, and typical leukorrhea that resembles tofu-like leukorrhea. The vulva and vagina may appear red and edematous.
The diagnosis of this disease is usually not difficult, a leucorrhoea test at the hospital can usually clarify the diagnosis, sometimes the leucorrhoea cannot detect Candida at once, a culture or the typical clinical symptoms can also help the diagnosis.
Under normal circumstances, there is lactobacillus in human vagina to maintain the weak acidic environment in the vagina, and pseudomonas is a common parasitic bacteria in women’s vagina; when the body resistance decreases, especially the local resistance, or when the virulence of pseudomonas increases, the body resistance is weaker than the invasion, which eventually leads to the proliferation of pseudomonas and the formation of VVC through the destruction of the body’s vaginal epithelial cells. VVC. pseudomonal yeast is not a bacterium, it is a type of fungus.
VVC alone is not difficult to treat, and can be treated with vaginal antifungal suppositories (the duration of the medication depends on the drug used), without the need for oral antifungal medication. Treatment of VVC alone can be done with one of the following treatment options.
Clotrimazole
Clotrimazole suppositories or clotrimazole tablets 500 mg in a single dose
Clotrimazole suppositories 100 mg once a night for 7 days
Miconazole
Miconazole softgels 1200 mg as a single dose
Miconazole suppository or Miconazole soft capsule 400 mg once a night for 3 days
Miconazole suppository 200 mg once a night for 7 days
Mycoplasma
100,000 units of mycoplasma effervescent tablets once a night for 14 days
Mycoplasma tablets 500,000 units once a night for 14 days
Fluconazole
Fluconazole 150mg, 1 dose
Some of the above drugs are over-the-counter and can be bought in pharmacies, but in the first occurrence, it is recommended to go to the hospital for diagnosis rather than to use the drugs indiscriminately by yourself. VVC is a fungal infection and should not be treated with bacterial “anti-inflammatory drugs”, as common antibacterial drugs are ineffective against fungi and may aggravate the fungal infection. Avoid sexual intercourse during treatment. It is only necessary to recheck the leukorrhea one week after treatment or at the next period.
About 84% of women experience a recurrence after the first VVC and the reasons for recurrence are varied. Pregnancy, oral contraceptive use, antibacterial use, diabetes, immunosuppression, and HIV infection are all factors that contribute to VVC recurrence, and some people will have a somatic susceptibility that is genetically related. Knowing these predisposing factors, you can consciously avoid them, such as avoiding the indiscriminate use of “anti-inflammatory drugs”.
The treatment of recurrent VVC begins with an investigation of the presence of the above-mentioned triggers for VVC. Treatment strategies include intensive treatment and consolidation therapy. Intensive treatment options may include one of the following.
Clotrimazole
Clotrimazole suppositories or tablets 500 mg on days 1, 4 and 7
Clotrimazole suppository 100 mg, applied once a night for 7 to 14 days
Miconazole
Miconazole suppository or softgel 400 mg once a night for 6 days
Miconazole suppositories 1200 mg on days 1, 4 and 7
Fluconazole
Fluconazole 150 mg in a single dose on days 1, 4, and 7
After a review to know that no fungus is present, the next step is to consolidate the treatment. There is no more mature protocol in China or abroad. For those who have regular attacks once a month, preventive medication can be administered once before each attack for 6 months. For those who have irregular episodes, medication can be given once a week for 6 months.
Sexual partners also do not need to be treated. About 15% of men have glansitis after contact with female patients, and symptomatic men should be examined and treated for pseudofilamentous yeast to prevent repeat infection in women.
VVC attacks during pregnancy are also a common problem. Medication is also available during pregnancy, but oral medication cannot be used during pregnancy. Of the vaginal suppositories, clotrimazole is a class B drug and is safe to use, miconazole and fluconazole are class C drugs and are not considered first
Prevention of mycosis fungoides
I often encounter patients asking me how to cure the root of the disease and never to recur. This can be very effective in blocking the invasion of various pathogens. On the other hand, it is also important to exercise regularly to strengthen your resistance.