Hematopoetic stem cell transplantation may be complicated by genital graft-versus-host (GVH) disease and may uncommonly result in labial fusion.
A 22-year-old woman with a history of Ewing’s sarcoma and acute myelogenous leukemia received chemotherapy and total-body irradiation followed by a matched, unrelated donor hematopoetic stem cell transplantation. After transplantation, she developed chronic GVH disease involving the skin, eyes, mouth, and joints. Concomitant vulvar pruritus was presumed to be a fungal infection but, in fact, was genital GVH disease manifesting as labial fusion. Topical estrogen, topical steroids, and surgical division of the labia were successful.
Genital GVH disease should be considered in women with genital tract complaints after hematopoetic stem cell transplantation. Labial fusion secondary to chronic GVH disease may be treated successfully with surgery and medical therapy.