title: Vaginal agglutination: chronic graft-versus-host disease mimics lichen planus.
abstract: BACKGROUND
  Graft-versus-host (GVH) disease is a common problem in transplant patients, whereas vulvovaginal gingival syndrome is an uncommon and severe variant of lichen planus characterized by erosions of characteristic mucosal surfaces, with frequent vaginal involvement, resulting in scarring or stricture formation. Both conditions have the potential to present with similar clinical pictures.
  
  
  METHODS
  We report the history, evaluation, and treatment of a woman who had recently undergone stem cell transplant for acute lymphoblastic leukemia who presented with vaginal agglutination. A clinical diagnosis of erosive lichen planus versus chronic GVH disease was considered.
  
  
  CONCLUSIONS
  Lichen planus and GVH disease are both inflammatory processes, which can present with a range of clinical conditions. Each may result in the development of irritative symptoms and erosive lesions on mucosal surfaces. Although lichen planus is a well-defined dermatosis, GVH disease is an iatrogenic process. We report the case history of a patient with erosive vulvovaginal lesions with scarring, likely caused by GVH disease, which mimicked erosive vulvovaginal lichen planus. Although the clinical presentation and treatment of these 2 entities are similar, this case demonstrates the subtle diagnostic difference between the 2 diseases.
authors.affiliation: Department of Obstetrics and Gynecology, The Ohio State University College of Medicine, Columbus, OH 43210-1267, USA. andrew.hundley@osumc.edu
authors.forename: Andrew F
authors.initials: AF
authors.lastname: Hundley
authors.forename: Cynthia
authors.initials: C
authors.lastname: Magro
authors.forename: Deborah
authors.initials: D
authors.lastname: Bartholomew
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006086:Graft vs Host Disease / Q000473:pathology*; D006801:Humans; D008010:Lichen Planus / Q000473:pathology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000628:therapy; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D014621:Vagina / Q000473:pathology*