Supplementary Material for: First Report of Successful Treatment of Erosive Vulvovaginal Lichen Planus with Platelet-Rich Fibrin: A Case Report and Comprehensive Literature Review

Introduction
Erosive vulvovaginal lichen planus is a chronic mucocutaneous disorder characterized by painful inflammation and mucosal erosions, significantly impacting patients’ quality of life. Regenerative medicine, particularly platelet-rich fibrin (PRF) injection, has emerged as a promising approach for managing inflammatory mucosal lesions.
Case Presentation
We describe a 72-year-old woman with long-standing mucocutaneous lichen planus involving the vulvovaginal and oral mucosa, as well as the scalp. Initial treatments included methotrexate, prednisolone, and mycophenolate mofetil, which resulted in resolution of the oral and scalp lesions, while the vulvovaginal erosions persisted and remained refractory. The patient subsequently received three monthly sessions of intralesional PRF injection, resulting in complete epithelialization of the vulvovaginal erosions and significant symptom relief, with no recurrence observed during follow-up.
Conclusion
While the efficacy of PRF has been previously reported in oral erosive lichen planus, this case is the first to document successful treatment of erosive vulvovaginal lichen planus using PRF. These findings highlight the potential of PRF as an effective, minimally invasive option for managing treatment-resistant mucosal lesions.