Treatment of vulvovaginal erosive and stenosing lichen planus by surgical dilatation and methotrexate.

We treated five patients with stenosing lichen planus [LP] of the vulvovaginal region with methotrexate supplemented with ultrapotent corticosteroid cream and tacrolimus, in combination with surgical dilatation. All patients experienced long-term symptom relief, and there was only minimal or moderate re-stenosing of the vagina on follow-up for 2-41 months.