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Best Pract Res Clin Obstet Gynaecol. 2014 Oct;28(7):1051-62. doi: 10.1016/j.bpobgyn.2014.07.010. Epub 2014 Jul 18.

Vulvar intraepithelial neoplasia.

Author information

1
Gynecological Oncologist, Department of Obstetrics and Gynecology, University of Turin, Via Ventimiglia 3, Turin, Italy. Electronic address: mario.preti@tin.it.
2
Anatomical Pathologist, FRCPA, Anatomical Pathology, HAPS, New Lambton, NSW 2305, Australia. Electronic address: jim.scurry@hnehealth.nsw.gov.au.
3
Chief Unit of Vulvar Diseases, Department of Gynecology, Hospital Italiano, Pavón 4239, Capital Federal, Buenos Aires, Argentina. Electronic address: claudia.marchitelli@hospitalitaliano.org.ar.
4
Associated Professor, Department of Obstetrics and Gynecology, University of Turin, Via Ventimiglia 3, Turin, Italy. Electronic address: l.micheletti@libero.it.

Abstract

Vulvar intraepithelial neoplasia (VIN) is a high-grade intraepithelial squamous lesion and precursor of invasive squamous cell carcinoma (SCC). The 2004 International Society for the Study of Vulvovaginal Disease (ISSVD) classification distinguished two types of VIN: usual type (human papillomavirus (HPV)-related) and differentiated type (not HPV-related). The incidence of usual-type VIN is higher in younger women, while differentiated-type VIN is more common in older patients with chronic dermatologic conditions. Differentiated-type VIN has a greater invasive potential and shorter time between diagnosis and SCC than usual-type VIN. The diagnosis of VIN is carried out by identifying a lesion by visual inspection and confirming by performing a biopsy. Screening tests are not available. Patients with usual-type VIN are at a higher risk of developing another HPV-related malignancy of the anogenital tract; therefore, examination from the cervix to the perianal area is mandatory. The therapeutic approach to VIN balances the invasive potential with the need to be as conservative as possible. Current prophylactic HPV vaccines offer protection against usual-type VIN and related invasive carcinoma.

KEYWORDS:

HPV; VIN; diagnosis; therapy; vulvar intraepithelial neoplasia

PMID:
25106700
DOI:
10.1016/j.bpobgyn.2014.07.010
[Indexed for MEDLINE]

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