Lichen planus is an autoimmune disorder that most commonly affects the mouth/gums (oral lichen planus) and/or vulovaginal area (known as erosive lichen planus). Lichen planus in the vulva/vaginal area looks bright red with lacy white borders and it can extend inside the vagina resulting in severe scarring and erosions. The symptoms include vaginal itching, large amounts of yellowish discharge, bleeding/tearing of the tissues, and pain.
Early diagnosis and prompt treatment is necessary to avoid destruction of the vulvovaginal tissues. This includes treatments such as topical steroids, hydrocortisone vaginal suppositories which is also used to treat hemorrhoids. When patients do not respond or have increased irritation with topical steroids, tacrolimus or pimecrolimus ointments may be beneficial.