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Case Report
Effects of vaginal lichen planus on pregnancy
1 Clinical Research Assistant in Obstetrics and Gynecology, Stony Brook University, Stony Brook, NY, USA
2 Resident Physician, Department of Obstetrics & Gynecology, Stony Brook University Hospital, Stony Brook, NY, USA
3 Assistant Professor in Obstetrics & Gynecology, Stony Brook University Hospital, Stony Brook, NY, USA
Address correspondence to:
Joseph W Bacchi III
III, MD, MBA, 101 Nicolls Road, HSC Level 9, Room 090, Stony Brook, NY 11794,
USA
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Article ID: 100121Z08BF2022
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Franz B, Fine E, Bacchi III JW. Effects of vaginal lichen planus on pregnancy. J Case Rep Images Obstet Gynecol 2022;8(1):29–32.ABSTRACT
Introduction: Lichen planus is an inflammatory condition that can affect the vulva and vagina. Although more common in women over 50 years of age, lichen planus can affect younger women and complicate pregnancy. During pregnancy, lichen planus can cause vaginal irritation, antepartum bleeding, and postpartum hemorrhages. It is imperative to maintain good control of the disease during pregnancy with topical corticosteroids.
Case Report: A 35-year-old female with a history of vaginal lichen planus, on vaginal hydrocortisone, presented to the labor and delivery ward in the active stage of labor. She proceeds with a vaginal delivery that is followed by a postpartum hemorrhage requiring a blood transfusion. The postpartum hemorrhage was secondary to bleeding from the vaginal mucosa that was intolerant to sutures. Bleeding was then controlled with topical hemostatic agents as well as vaginal packing.
Conclusion: Uncontrolled vaginal lichen planus can be associated with postpartum hemorrhage at the time of delivery. Some providers may recommend a cesarean section to prevent these outcomes; however, instead it is recommended to focus on adequate control of the disease prior to delivery and to proceed with a vaginal delivery. Standard regimens of topical corticosteroids can be safe and effective at preventing flares of lichen planus in pregnancy. In the event of a postpartum hemorrhage secondary to lichen planus, topical hemostatic agents and vaginal packing should be implemented as means to minimize blood loss.
Keywords: Complications, Lichen planus, Pregnancy, Treatment
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Acknowledgments
Stony Brook University Hospital
Author ContributionsBrynn Franz - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Eliana Fine - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Joseph W Bacchi III - Substantial contributions to conception and design, Acquisition of data, Analysis of data, Interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Guaranter of SubmissionThe corresponding author is the guarantor of submission.
Source of SupportNone
Consent StatementWritten informed consent was obtained from the patient for publication of this article.
Data AvailabilityAll relevant data are within the paper and its Supporting Information files.
Conflict of InterestAuthors declare no conflict of interest.
Copyright© 2022 Brynn Franz et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.
