What condition presents with burning, diffuse yellow/brown discharge, and dyspareunia that does not respond to local estrogen therapy?

The condition described is associated with burning sensations, a diffuse yellow or brown discharge, and dyspareunia (painful intercourse) that does not improve with local estrogen therapy. This presentation is characteristic of desquamative inflammatory vaginitis. This condition is often marked by inflammation of the vaginal epithelium, leading to symptoms such as burning and discharge. The vaginitis is a non-infectious condition that can be identified by its response to various treatments, with local estrogen typically showing minimal effect.

In contrast, vulvar lichen sclerosus often presents with itching and white patches on the vulva, while atrophic vaginitis primarily occurs due to thinning and drying of vaginal tissues, typically showing an improvement in symptoms with estrogen therapy. Vulvar vestibulitis syndrome, on the other hand, is characterized by localized pain and discomfort at the vestibule of the vagina but does not typically feature the discharge described in this condition.

Therefore, the combination of symptoms—particularly the nature of the discharge and the lack of response to estrogen—aligns specifically with desquamative inflammatory vaginitis, making it the correct choice.