OBJECTIVE--To determine whether zinc deficiency in serum or vulvovaginal secretion is a risk factor for recurrent vulvovaginal candidiasis. DESIGN--Prospective and controlled study. SETTING--Department of Dermatology, University of Vienna. SUBJECTS--21 women who had experienced at least three documented episodes of acute vulvovaginal candidiasis within the previous 12 months. Fifteen women without anamnesis of vulvovaginal candidiasis as a control group. INTERVENTIONS--Blood samples were drawn for measurement of plasma zinc levels. Lavage of the vagina and ectocervix was performed with sterile saline solution for measurement of cervicovaginal zinc levels. MAIN OUTCOME MEASURES--Zinc levels of serum and cervicovaginal secretions were determined by flame atomic absorption spectrophotometry. RESULTS--We found no significant difference in the mean zinc concentration of plasma and cervicovaginal secretions between the recurrent vulvovaginal candidiasis and the control group. (p value for serum = 0.71, p value for secretion = 0.80). Zinc levels of plasma and cervicovaginal secretions showed no correlation (patient group: r = -0.05, control group: r = -0.07). CONCLUSION--It is well known that zinc not only exerts a major impact on different immune functions, but also participates in growth and morphogenesis of Candida albicans. Our results could not confirm the previous hypothesis that zinc deficiency of serum is a risk factor in recurrent vulvovaginal candidiasis. It is possible that the local zinc level of cervicovaginal secretions essentially influences antifungal activity of third generation azole antimycotics.
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