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1,5 A previous six-month trial of weekly treatment with fluconazole reported a reduced rate of recurrence of symptomatic RVVC.5 Treatment with this antifungal was generally well tolerated, and there was no evidence of liver toxicity or azole resistance in isolates of Candida albicans or other subspecies. However, this therapy was not effective at preventing recurrent episodes.5 Although research has been conducted to investigate the pathogenic mechanisms involved for balancing resistance and tolerance for RVVC and various treatment modalities for this disorder have been investigated, no effective long term cure has been found that works for all women. Meech et al. suggested that both immunoglobulin E (IgE)-mediated [https://en.wikipedia.org/wiki/Chloramben Chloramben] and/or cellular-mediated hypersensitivity mechanisms may be involved in these local infections.6 They emphasized the need to recognize the nature of the host response to C. albicans to understand and treat the various clinical presentations of these infections.6 Witkin et al. demonstrated that some of [http://www.selleckchem.com/products/hydroxychloroquine-sulfate.html Hydroxychloroquine molecular weight] these women have an abnormal macrophage response to C. albicans.4 They postulated that the macrophages of these women produce increased levels of prostaglandin E2, which inhibits the lymphocyte proliferative response to Candida antigen.4 Witkin et al. previously demonstrated that the vaginal secretions of many women with RVVC contain anti-Candida IgE antibodies and detectable levels of prostaglandin E2.7 This observation led to speculation that a vaginal hypersensitivity response to C. albicans may be associated with increased levels of prostaglandin E2, which is capable of suppressing localized vaginal cell-mediated immune responses.7 The loss of this localized vaginal defense mechanism can result in colonization by yeast leading to repetitive infections. There have previously been anecdotal reports claiming success in desensitizing women with RVVC.3,8 Rigg et al. evaluated recurrent allergic vulvovaginitis in 18 women who had a positive prick or intracutaneous skin test to C. albicans.9 These women received conventional immunotherapy to C. albicans over one year. Approximately [http://www.selleckchem.com/screening/chemical-library.html Bioactive Compound Library order] 79% of these subjects had a favorable response with the mean number of vaginitis episodes decreasing from 17.2 �� 2 to 4.3 �� 1.8 (p