Vulvovaginal Graft-Versus-Host Disease

Rachel I Kornik; Alison S Rustagi

doi:10.1016/j.ogc.2017.05.007

Vulvovaginal Graft-Versus-Host Disease

Obstet Gynecol Clin North Am. 2017 Sep;44(3):475-492. doi: 10.1016/j.ogc.2017.05.007.

Authors

Rachel I Kornik¹, Alison S Rustagi²

Affiliations

¹ Department of Dermatology, University of Wisconsin, 1 South Park Street, 7th Floor, Madison, WI 53715, USA. Electronic address: rkornik@dermatology.wisc.edu.
² UCSF School of Medicine, 505 Parnassus Avenue, San Francisco, CA 94143, USA.

PMID: 28778644
DOI: 10.1016/j.ogc.2017.05.007

Abstract

Vulvovaginal chronic graft-versus-host disease (cGVHD) is an underrecognized complication of stem cell transplantation. Early recognition may prevent severe sequelae. Genital involvement is associated with oral, ocular, and skin manifestations. Treatment includes topical immunosuppression, dilator use, and adjuvant topical estrogen. Clinical and histologic features may mimic other inflammatory vulvar conditions. In the right clinical context, these findings are diagnostic of chronic GVHD. Female recipients of allo-hematopoietic stem cell transplantation (HCT) are at higher risk of condylomas, cervical dysplasia, and neoplasia. The National Institutes of Health publishes guidelines for the diagnosis, grading, management, and supportive care for HCT patients by organ system.

Keywords: Genital; Graft-versus-host disease; Hematopoietic stem cell transplant; Vulvovaginal.

Publication types

Review

MeSH terms

Chronic Disease
Female
Graft vs Host Disease / diagnosis*
Graft vs Host Disease / etiology
Graft vs Host Disease / physiopathology
Graft vs Host Disease / therapy
Hematopoietic Stem Cell Transplantation / adverse effects*
Humans
Vaginal Diseases / diagnosis*
Vaginal Diseases / etiology
Vaginal Diseases / therapy
Vulvar Diseases / diagnosis
Vulvar Diseases / etiology*
Vulvar Diseases / therapy