Mosiac punctations on vaginal exam for vulvar dysplasia
Where should the biopsies be taken?
Coarse punctation and/or coarse mosaics in acetowhite areas tend to occur in . found on the cervix, but more commonly in the vagina or on the vulva.
Colposcopy and treatment of cervical intraepithelial neoplasia: a beginnersÂ’ manual
Description:It is important that the information she is given before the examination quells her anxiety. To identify cell changes iodine cannot be used alone because immature epithelium does not turn brown. Use green light to identify atypical blood vessels before coating with acetic acid. Areas with mixed red and white after application of acetic acid, but with a ulcerated surface. High-grade CIN are associated with thick, dense, dull, opaque or greyish-white acetowhite areas with well-demarcated, regular margins, which sometimes may be raised and rolled out. It is important to take biopsies in areas where the most severe changes in lesions are observed, but most often the highest level of VIN is located in a lesion closest to SCJ. Metaplasia becomes thin acetowhite and may be difficult to distinguish from low-grade CIN.
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