Vulvar Dysplasia

The vulva is a woman’s external genitalia and includes:

  • Inner and outer lips of the vagina
  • Clitoris (sensitive tissue between the lips)
  • Opening of the vagina and its glands
  • Mons pubis (the rounded area in front of the pubic bones that becomes covered with hair at puberty)
  • Perineum (the area between the vulva and the anus)

Risk factors:

  • Older age
  • Having HPV
  • History of genital warts
  • High number of sexual partners
  • First sexual encounter at a young age
  • History of abnormal pap smears
  • History of other cancers (melanoma, cervical)
  • Lichen sclerosis
  • HIV
  • Smoking

Vulvar dysplasia, also referred to as vulvar intraepithelial neoplasia (VIN), describes abnormal cells found on the surface layer of the vulvar tissue. 

  • VIN is not cancer, but is a precancerous change that can develop into cancer. Vulvar dysplasia
    ranges from mild to moderate to severe and is synonymous with VIN 1, VIN 2 and VIN 3 with the
    number 3 indicating the furthest progression towards cancer.

Vulvar dysplasia often does not cause early signs or symptoms and the most common complaints may also be caused by other conditions. 
Therefore, it is important to check with a doctor if you have any of the following:

  • Vulvar tissue that is thickened, lighter or darker then surrounding tissue.
  • Itching in the vulvar area that does not go away.
  • A lump or growth on the vulva that looks like a wart or ulcer.
  • Bleeding not related to menstruation (periods).
  • Pain in the vulvar area.

Testing used to diagnose vulvar dysplasia include:

  • Health history of any reported symptoms.
  • Physical exam to examine the vulva for abnormalities.
  • Biopsy of abnormal vulvar tissue, sent to pathology for diagnosis.

Treatment for vulvar dysplasia is aimed at preventing the development into vulvar cancer and will be individualized and determined by your physician.
Treatment options include:

  • Topical therapy with Aldara (Imiquimod) works by boosting the body’s immune response to the
    area of abnormal tissue.
  • Topical steroids may be used in lichen sclerosus to thin the tissue, prevent progression and relieve
  • CO2 laser uses high intensity energy from a light beam to destroy abnormal areas
  • Surgical resection to remove the abnormal tissue without any loss of the woman’s sexual function,
    but is based on location. May require more than one surgery, depending on margin status and
    depth of invasion.

Ways you can reduce your risk of developing vulvar dysplasia:

  • Obtain routine health screenings including well women exams and pap smears.
  • Don’t smoke or stop smoking.
  • Practice safe sexual practices by limiting partners and using condoms.
  • Get the HPV vaccine – This vaccine is available for all boys and girls aged 9 and 26 and is approved by the FDA & CDC for adults aged 27-45.
  • The HPV vaccine is not recommended for everyone older then 27 and is most effective when given at a young age, before exposure to HPV.
  • However, older individuals at risk for acquiring a new HPV infection in the future with new partners, might benefit from vaccination.

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