Vaginal Stenosis Due to Bullous Erythema Multiforme (Stevens‐johnson Syndrome)

Abstract

Summary Bullous erythema multiforme is a disorder in which oral and genital erosions, ocular inflammation and cutaneous bullae may follow a viral or bacterial infection or the ingestion of certain drugs, such as sulphonamides. Unpleasant sequelae have been reported including residual scarring, and death may occasionally result from infection or renal failure; severe scarring can cause blindness and infrequently the genital tract is involved. We report a patient who developed complete vaginal stenosis following bullous erythema multiforme in pregnancy.

Non‐Infective Cutaneous Conditions of the Vulva

“…5.33). Vaginal stenosis (Graham-Brown et al 1981) and vulvovaginal adenosis (Emberger et al 2006) have been described as sequelae (see below).…”

Stevens-Johnson syndrome and toxic epidermal necrolysis in pregnant patients: A systematic review

“… BSA, body surface area; CS, cesarean section; GA, gestational age; ICU, intensive care unit; IVIG, intravenous immunoglobulin; LOE, level of evidence; Rx, prescription; SJS, Stevens-Johnson syndrome; TEN, toxic epidermal necrolysis; Tx; treatment. References: Agboghoroma et al, 2010 , Ahiskalioglu et al, 2017 , Claessens et al, 1998 , de Haan et al, 2018 , Dube et al, 2013 , Graham-Brown et al, 1981 , Hitti et al, 2004 , Joao et al, 2006 , Knight et al, 2015 , Lee et al, 2010 , Leung, 1985 , Marazzi et al, 2006 , Niemeijer et al, 2009 , Pacheco et al, 2002 , Rodriguez et al, 2006 , Shiba et al, 2010 , Shilad et al, 2005 , Stewart et al, 2016 , Struck et al, 2010 , Sweetnam et al, 1964 , Treichler and Horvath, 1964 , Ugburo et al, 2009 , Vasicka et al, 1958 , Velter et al, 2018 , Winston and Mastroianni, 1954 , Yanagida, 2002 . …”

Complications of Stevens–Johnson syndrome beyond the eye and skin

“…In 1981, the vulvae of a 25-year-old female with acute SJS/TEN were characterized as edematous, inflamed and ulcerated. This patient went on to develop complete vaginal stenosis beyond the introitus, 2-3 months after resolution of acute SJS/TEN [76]. Since then, both the acute and chronic gynecologic manifestations of SJS/TEN have been well described.…”

“…Many other smaller reports have also described vulvar pain and dyspareunia following SJS/TEN. Examination of these patients revealed vulvar and vaginal adenosis, vaginal stenosis, fusion of the labia minora and majora, and cases of complete vaginal fusion leading to hematocolpos and hydrocolpos [76,[78][79][80][81][82][83][84][85][86]. All of these findings place significant limits on meaningful menstruation and may result in subfertility or frank infertility [86,87].…”