Chronic graft-versus-host disease revealed by lichenoid vulvar lesions successfully treated with thalidomide.

Sir, Chronic graft-versus-host disease (GVHD) occurs in approximately 60 – 80% of patients who survive for 100 days after allogeneic bone marrow transplantation (BMT) (1). The skin is affected in almost all cases of chronic GVHD, with two distinct phases: the early chronic phase, characterized by lichenoid lesions similar to lichen planus, and the late chronic phase, with sclerodermatous lesions. During the early course, the clinical spectrum of lichen planus may be reproduced, and the initial lesions are usually in the buccal mucosa. Rarely has genital mucosa been reported during chronic GVHD. We describe a case of chronic GVHD in a 40-year-old woman successfully treated with thalidomide at a dose of 100 mg per day. GVHD manifested in erosive lichen-planus-like lesions of the vulva following allogeneic BMT for chronic myeloid leukaemia.