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Vulval intraepithelial neoplasia

J Kentley, R Cerio, M Khorshid, K Gibbon
We report the case of a 24-year-old woman with an 8-month history of deep pelvic pain and postcoital bleeding. Examination revealed desquamation of the vaginal epithelium with tender fissured plaques in the vagina, initially thought to be vaginal intraepithelial neoplasia. Histology showed squamous mucosa with suprabasal acantholysis and hyperkeratosis, and no evidence of viral infection, dysplasia or malignancy. These findings were consistent with acantholytic dermatosis (AD), a rare lesion that resembles Hailey-Hailey and Darier disease histopathologically, but can be distinguished on a clinical basis...
January 4, 2017: Clinical and Experimental Dermatology
Kate Coffey, Kezia Gaitskell, Valerie Beral, Karen Canfell, Jane Green, Gillian Reeves, Isobel Barnes
BACKGROUND: Vulval cancer predominantly affects postmenopausal women. A smaller proportion of vulval cancers, particularly at older ages, are now thought to be associated with human papillomavirus infection than previously reported, but other risk factors have not been well examined in prospective cohort studies. METHODS: A total of 1.3 million women aged 49-65 years were followed for incident vulval cancer (ICD-10 C51). Adjusted Cox regression models were used to examine the relationship between reproductive and lifestyle factors and risk of vulval cancer...
August 23, 2016: British Journal of Cancer
Jackie Hilton, Nicky Perkins, Sepehr N Tabrizi, Ronald W Jones
OBJECTIVE: To review the clinical features, demography and human papillomavirus (HPV) genotype in a group of young women with usual type vulval intraepithelial neoplasia (VIN) whose lesions regressed spontaneously. MATERIALS AND METHODS: A retrospective case note review was made of the records of women with a diagnosis of usual type VIN whose lesions resolved spontaneously. The clinical features, demography, associated conditions, time to regression and follow-up data were extracted...
June 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
Henriëtte S de Bruijn, Sander Brooks, Angélique van der Ploeg-van den Heuvel, Timo L M Ten Hagen, Ellen R M de Haas, Dominic J Robinson
BACKGROUND: Light fractionation significantly increases the efficacy of 5-aminolevulinic acid (ALA) based photodynamic therapy (PDT) using the nano-emulsion based gel formulation BF-200. PDT using BF-200 ALA has recently been clinically approved and is under investigation in several phase III trials for the treatment of actinic keratosis. This study is the first to compare BF-200 ALA with ALA in preclinical models. RESULTS: In hairless mouse skin there is no difference in the temporal and spatial distribution of protoporphyrin IX determined by superficial imaging and fluorescence microscopy in frozen sections...
2016: PloS One
Gemma L Owens, Henry C Kitchener
Cervical intraepithelial neoplasia (CIN) is the most common premalignant disease of the lower genital tract encountered during pregnancy. As in the non-pregnant state, abnormal cytology should be referred for colposcopy. However, the role of colposcopy in pregnant women is to exclude invasive cancer by visual inspection and defer biopsy and definitive treatment until the post-partum period. Colposcopic exclusion of invasive disease is the only absolute indication for conisation in pregnancy. It is now evident that treatment for CIN outside of pregnancy, that involves >15 mm deep excision is associated with an increased risk of preterm delivery...
May 2016: Best Practice & Research. Clinical Obstetrics & Gynaecology
M Toby, K Conway, G Sethi, F Lewis
BACKGROUND: Usual or undifferentiated type vulval intraepithelial neoplasia is more common in young women and is usually associated with high-risk human papilloma virus infection. It is associated with the development of basaloid or warty squamous cell carcinoma. Studies have shown that HIV-positive women have an increased risk of VIN and invasive vulval carcinoma but there is a paucity of data about this cohort of women. OBJECTIVE: To describe the clinical features and treatment response of HIV-positive women diagnosed with vulval intraepithelial neoplasia in a specialist vulval dermatology clinic...
October 14, 2015: International Journal of STD & AIDS
Jin Wu, Ying Jia, Ming Luo, Zhaoning Duan
AIM: The aim of this study was to analyze residual/recurrent disease and its risk factors as well as the appropriate frequency of follow-up cytology and human papillomavirus (HPV) tests after loop electrosurgical excision procedure (LEEP) for CIN2/3. METHODS: We retrospectively analyzed 835 patients with CIN2/3 who were treated with LEEP. Post-LEEP follow-up was performed using liquid-based cytology tests or/and HPV DNA tests. Residual/recurrent disease was defined as biopsy-proven CIN2/3; cervical cancer and vulval intraepithelial neoplasia were not considered as residual/recurrent cases...
2016: Gynecologic and Obstetric Investigation
Melanie Henes, Bernhard Vogt, Felix Neis, Katharina Rall, Tanja Litzenburger, Diethelm Wallwiener, Sara Y Brucker, Ralf Rothmund
OBJECTIVE: Evaluation of safety, feasibility, and possibilities of the thulium laser, Vela(®), with a wavelength of 1.9 μm for laser treatment of the portio, vagina, and/or vulva. BACKGROUND DATA: Laser techniques have been used for many years in the gynecological setting for the treatment of cervical, vaginal, and vulval intraepithelial neoplasias (CIN, VAIN, VIN) and also for the treatment of condylomas. To date, the most commonly used laser for this treatment is the CO2 laser...
September 2015: Photomedicine and Laser Surgery
Litha Pepas, Sonali Kaushik, Andy Nordin, Andrew Bryant, Theresa A Lawrie
BACKGROUND: This is an updated version of a review first published in theCochrane Database of Systematic Reviews, Issue 4, in 2011. Vulval intraepithelial neoplasia (VIN) is a pre-cancerous condition of the vulval skin and its incidence is increasing in women under 50 years. High-grade VIN (also called usual-type VIN (uVIN) or VIN 2/3 or high-grade vulval intraepithelial lesion) is associated with human papilloma virus (HPV) infection and may progress to vulval cancer, therefore is usually actively managed...
August 18, 2015: Cochrane Database of Systematic Reviews
Ying Jia, Jin Wu, Man Xu, Liangdan Tang, Chengzhi Li, Ming Luo, Meng Lou
OBJECTIVES: Focused ultrasound waves penetrate superficial tissues and are aimed toward the target tissues at specific depths to exert their biological effects. Focused ultrasound has been applied for a number of clinical indications, including vulval dystrophies and low-grade vulval disease. This study aimed to assess the efficacy and safety of focused ultrasound treatment of high-grade vulval intraepithelial neoplasia (VIN). METHODS: Eighteen women with high-grade VIN were recruited and treated with focused ultrasound...
November 2014: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Sven Mahner, Linn Wölber
No abstract text is available yet for this article.
November 2014: Lancet Oncology
Amanda Tristram, Christopher N Hurt, Tracie Madden, Ned Powell, Stephen Man, Sam Hibbitts, Peter Dutton, Sadie Jones, Andrew J Nordin, Raj Naik, Alison Fiander, Gareth Griffiths
BACKGROUND: Vulval intraepithelial neoplasia is a skin disorder affecting the vulva that, if left untreated, can become cancerous. Currently, the standard treatment for patients with vulval intraepithelial neoplasia is surgery, but this approach does not guarantee cure and can be disfiguring, causing physical and psychological problems, particularly in women of reproductive age. We aimed to assess the activity, safety, and feasibility of two topical treatments--cidofovir and imiquimod--as an alternative to surgery in female patients with vulval intraepithelial neoplasia...
November 2014: Lancet Oncology
Dean Bryant, Tiffany Onions, Rachel Raybould, Sadie Jones, Amanda Tristram, Samantha Hibbitts, Alison Fiander, Ned Powell
BACKGROUND: Methylation of HPV16 DNA is a promising biomarker for triage of HPV positive cervical screening samples but the biological basis for the association between HPV-associated neoplasia and increased methylation is unclear. OBJECTIVES: To determine whether HPV16 DNA methylation was associated with viral integration, and investigate the relationships between viral DNA methylation, integration and gene expression. STUDY DESIGN: HPV16 DNA methylation, integration and gene expression were assessed using pyrosequencing, ligation-mediated PCR and QPCR, in biopsies from 25 patients attending a specialist vulval neoplasia clinic and in short-term clonal cell lines derived from vulval and vaginal neoplasia...
November 2014: Journal of Clinical Virology: the Official Publication of the Pan American Society for Clinical Virology
Susanne Booth, David Poole, Keyvan Moghissi
OBJECTIVES: To assess the suitability and effectiveness of photodynamic therapy (PDT) in the treatment and symptom relief of vulval intraepithelial neoplasia (VIN), other pre-malignant and early neoplastic conditions of the vulva in an out patient setting. METHODS: Patients were selected from the vulvoscopy clinic whilst being investigated or under long-term follow-up. PDT was offered to patients in whom other treatments had failed or were unsuitable. 5-Aminoleuvinic acid (5-ALA) was used as a topical pro-drug, inducing the photosensitiser protoporphyrin IX...
September 2006: Photodiagnosis and Photodynamic Therapy
Dean Bryant, Tiffany Onions, Rachel Raybould, Áine Flynn, Amanda Tristram, Sian Meyrick, Peter Giles, Kevin Ashelford, Samantha Hibbitts, Alison Fiander, Ned Powell
Vulval intraepithelial neoplasia is a precursor of vulval cancer and is commonly caused by infection with Human Papillomavirus (HPV). Development of topical treatments for vulval intraepithelial neoplasia requires appropriate in vitro models. This study evaluated the feasibility of primary culture of vulval intraepithelial neoplasia biopsy tissue to produce cell lines for use as in vitro models. A potentially immortal cell line was produced which gave rise to three monoclonal lines. These lines were characterized for HPV genomic integration and for viral gene expression using ligation-mediated PCR and quantitative PCR...
September 2014: Journal of Medical Virology
Lars-Christian Horn, Ursula Katharina Bauerfeind, Hans-Georg Strau, Ina Karbe
The occurrence of ectopic intestinal/enteric-type epithelium at the vulva is a rare entity sometimes mimicking intraepithelial neoplasia or malignant disease. Here, we report a case of an 82-yr-old woman with a long-standing (10 yr) white papillary lesion with some reddish areas at her left labium, extending into the vaginal introitus. Biopsy reports revealed colonic-type glandular epithelium with positive immunostaining against CDX-2, p53, CK 7, and CEA, whereas staining against estrogen and progesterone receptor, mammoglobin, GCDFP-15, and CK 20 was reported to be negative...
May 2014: International Journal of Gynecological Pathology
Sonali Kaushik, Litha Pepas, Andy Nordin, Andrew Bryant, Heather O Dickinson
BACKGROUND: This is an updated version of an original Cochrane review published in The Cochrane Library, 2011, Issue 1.Vulval intraepithelial neoplasia (VIN) is a pre-malignant condition of the vulval skin. This uncommon chronic skin condition of the vulva is associated with a high risk of recurrence and the potential to progress to vulval cancer. The condition is complicated by its multicentric and multifocal nature. The incidence of this condition appears to be rising, particularly in the younger age group...
2014: Cochrane Database of Systematic Reviews
Ada Miltz, Huw Price, Maryam Shahmanesh, Andrew Copas, Richard Gilson
BACKGROUND: It is unclear whether L1-VLP-based human papillomavirus (HPV) vaccines are efficacious in reducing the likelihood of anogenital pre-cancer in women with evidence of prior vaccine-type HPV exposure. This study aims to determine whether the combined results of the vaccine trials published to date provide evidence of efficacy compared with control (hepatitis A vaccine/placebo). METHODS: A systematic review and meta-analysis was conducted. Randomized-controlled trials (RCTs) were identified from MEDLINE, Embase, Web of Science, PubMed, Cochrane Central Register of Controlled Trials and references of identified studies...
2014: PloS One
Susan M Bigby, Lois J Eva, Ronald W Jones
Spindle cell or sarcomatoid squamous cell carcinoma is an uncommon variant of squamous cell carcinoma of the vulva (SCCV) with only 12 well-documented cases reported to date. Morphologically tumors may be biphasic or monophasic, and uncommonly include heterologous elements. Only 1 reported vulval tumor has previously been investigated for human papillomavirus DNA content. We describe 4 women with spindle cell (sarcomatoid) SCCV, 3 of which occurred de novo and 1 followed radiotherapy for previous SCCV. The tumors in all 4 women arose in a background of lichen sclerosus, and 3 were associated with vulval intraepithelial neoplasia differentiated (simplex) type...
March 2014: International Journal of Gynecological Pathology
J Chovanec, L Mouková, R Feranec
For preinvasive lesions of vulva, a common term VIN -  vulval intraepithelial neoplasia is used. VIN is a histological dia-gnosis based on abnormal squamous epithelial proliferation. There are two types of VIN apart from their association with human papillomavirus (HPV). Undifferentiated (usual) vulval intraepithelial neoplasia is commonly associated with carcinogenic genotypes of HVP, whereas differentiated vulval intraepithelial neoplasia is not associated with high-risk genotypes of HPV. The article presents an overview of VIN occurence and epidemiology, its classification system and dia-gnostics...
2013: Klinická Onkologie: Casopis Ceské a Slovenské Onkologické Spolecnosti
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