Screening genitalia for chronic GVHD

Evaluation

Biopsy

Clinical manifestation	Description
Lichen planus-like features	Erythematous/violaceous tissue changes
Lichen sclerosus-like features	White, atrophic papules that may coalesce into plaques
Females: Vaginal scarring or clitoral/ labial agglutination	A narrowing of the vagina, often with accompanying tissue changes such as dryness, loss of elasticity and resilience, adhesion and scar tissue
Males: Phimosis or urethral/meatus scarring or stenosis	N/A

Clinical manifestation	Description
Fissures*	A break or slit in tissue typically appearing at the junction of skin and mucous membrane
Erosions*	Localized destruction or loss of the epidermis
Ulcers*	Localized destruction or loss below the epidermis
Pterygium unguis*	Forward growth of the cuticle over the nail

* Distinctive but insufficient alone to establish an unequivocal diagnosis of chronic GVHD without further testing or additional organ involvement.

** Rare, controversial, or non-specific features of chronic GVHD.

*** Common in both acute and chronic GVHD.