Operational Obstetrics & Gynecology

Vulvar Intraepithelial Neoplasia (VIN)

VIN III

VIN is a premalignant condition, which if untreated can lead to invasive cancer of the vulva.

In the cervix, premalignant changes occur (CIN I, CIN II and CIN III) which precede the development of invasive cancer by many months or years.

In the case of the vulva, the same principle applies, that there are premalignant changes which may ultimately lead to cancer of the vulva. The degree of change is similarly labeled, VIN I, VIN II and VIN III (also known as "carcinoma-in-situ).

Clinically, these patient usually present with vulvar itching which does not respond to anti-fungal agents. Closer inspection visually will show the skin to have a white discoloration which can be enhanced with the application of acetic acid.

Milder forms of VIN may not be obvious visually and special testing, such as the use of Toluidine Blue staining, may be necessary to identify the area of abnormality.

The diagnosis is confirmed with vulvar biopsy.

Treatment involves local excision, or in selected cases laser vaporization. Close follow-up is very important should there be persistence or recurrence of disease.

Home ╖ Introduction ╖ Medical Support of Women in Field Environments ╖ The Prisoner of War Experience ╖ Routine Care ╖ Pap Smears ╖ Human Papilloma Virus ╖ Contraception ╖ Birth Control Pills ╖ Vulvar Disease ╖ Vaginal Discharge ╖ Abnormal Bleeding ╖ Menstrual Problems ╖ Abdominal Pain ╖ Urination Problems ╖ Menopause ╖ Breast Problems ╖ Sexual Assault ╖ Normal Pregnancy ╖ Abnormal Pregnancy ╖ Normal Labor and Delivery ╖ Problems During Labor and Delivery ╖ Care of the Newborn

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Operational Obstetrics & Gynecology - 2nd Edition
The Health Care of Women in Military Settings
CAPT Michael John Hughey, MC, USNR
NAVMEDPUB 6300-2C
January 1, 2000

This web version of Operational Obstetrics & Gynecology is provided by The Brookside Associates Medical Education Division. It contains original contents from the official US Navy NAVMEDPUB 6300-2C, but has been reformatted for web access and includes advertising and links that were not present in the original version. This web version has not been approved by the Department of the Navy or the Department of Defense. The presence of any advertising on these pages does not constitute an endorsement of that product or service by either the Department of Defense or the Brookside Associates. The Brookside Associates is a private organization, not affiliated with the United States Department of Defense. All material in this version is unclassified.

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