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Vulvar Intraepithelial Neoplasia

Vulvar intraepithelial neoplasia lesions are often associated with HPV. Studies have found HPV-DNA in the majority of cases of VIN. Multiple types of HPV are found within the lesions, most commonly HPV-16 but also other types, such as HPV-18 and HPV-33. Physicians now postulate that two types of VIN exist--one that is associated with HPV and one that is not. Most patients with HPV-associated VIN are significantly younger than those with VIN not associated with vulvar intraepithelial neoplasia, vulva intraepithelial neoplasia, vulva cancer, valva. HPV is considered by some to be one of the most common sexually transmitted diseases (STDs). Smoking may be a concomitant factor in the development of

With high rates of sexual activity among teenagers, as well as multiple sexual partners and early age of first sexual encounter, the incidence in adolescents is 

The appearance of VIN-1 and VIN-2 is usually a 

TABLE 1 -- NOMENCLATURE OF VULVAR INTRAEPITHELIAL NEOPLASIA
New Nomenclature  
VIN-1 Mild dysplasia
VIN-2 Moderate dysplasia
VIN-3 Bowen's disease, severe dysplasia, squamous cell carcinoma in situ, erythroplasia of Queyrat
VIN = vulvar intraepithelial neoplasia.
 

slightly raised, white, and rough area. VIN can be found anywhere on the vulva but is most commonly on the posterior fourchette and perineum. It may be asymptomatic, or it may present with itching and burning. The diagnosis is made by biopsy. Multiple biopsy sites are recommended because different grades of lesions can be present at the vulvar intraepithelial neoplasia, vulva intraepithelial neoplasia, vulva cancer, valva

The appearance of VIN-3 is fairly varied. It ranges from 

 It is usually multifocal. Ulceration, induration, and granularity should raise the suspicion for invasive cancer. These lesions are not common in teenagers because they usually take years to develop but can be found in those that are immunocompromised (e.g., those with HIV) or women who were sexually abused at an early age. When the diagnosis is established by vulvar biopsy, adolescents should be referred to a gynecologist for surgical excision or laser treatment. Recurrence is

Treatment