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Recurrent Vulvovaginal Candidiasis — SCE Dermatology MCQ

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ModerateGenital DermatologyRecurrent Vulvovaginal CandidiasisSCE Dermatology

A 42-year-old woman presents with recurrent vulvovaginal candidiasis (≥4 episodes per year). She has no diabetes or immunosuppression. What is the recommended management approach?

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Correct answer: D — Induction with oral Fluconazole 150 mg every 72 hours for 3 doses then maintenance Fluconazole 150 mg weekly for 6 months

For recurrent vulvovaginal candidiasis (RVVC, ≥4 microbiologically confirmed episodes per year), BASHH and BAD guidelines recommend an induction-maintenance regimen: induction with oral Fluconazole 150 mg every 72 hours for 3 doses (days 1, 4, 7), followed by maintenance oral Fluconazole 150 mg once weekly for 6 months. Approximately 90% remain disease-free during maintenance, but 50% relapse after cessation. Vulval care advice (avoiding irritants, using emollients as soap substitutes) is important. Non-albicans species (particularly C. glabrata) may cause treatment-resistant RVVC and should be identified by culture.

Reference: BASHH 2019 VVC Guidelines; BAD