Dilation and evacuation for fetal demise in a patient with presumed erythema multiforme major: A case report

BACKGROUND: Erythema multiforme is a rare dermatologic condition. There is limited data on the effects of erythema multiforme on the vulva, vagina, and pregnancy. CASE: This case report describes a 32-year-old woman with erythema multiforme major with vulvovaginal involvement, found to have a fetal demise measuring 16 weeks' gestation. Dilation and evacuation was performed and was complicated by vaginal adhesions. The adhesions were lysed intraoperatively and managed postoperatively with vaginal dilators and topical corticosteroids for three months. At six weeks postoperatively, the vulvovaginal lesions had completely healed with no residual scarring or stenosis. CONCLUSION: Erythema multiforme with vulvovaginal involvement can complicate obstetrical procedures and requires a multidisciplinary approach. In this instance, pain control, topical corticosteroids, and vaginal dilators produced favorable clinical outcomes.