VIN

Question 1

What are the two types of VIN?

Answer 1

Differentiated VIN (dVIN)
- non HPV
- associated with LS and LSC

Vulvar HSIL
- HPV mediated

Question 2

Treatment options?

Answer 2

WLE
Laser ablation
Imiquimod (3x per week for up to 20 weeks)

Question 3

When to biopsy?

Answer 3

Low threshold.
Persistent lesions
Rapidly changing lesions
Atypical vascularity
Irregular colors
Irregular borders
Genital warts in postmenopausal patients

Question 4

Do negative margins after WLE indicate no recurrence risk?

Answer 4

No.
Negative margins reduce but do not eliminate recurrence risk. Needs annual examinations.

(positive margins and smoking increase recurrence risk)