Atlas of Colposcopy: Principles and Practice

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Cervicovaginal inflammation – Inflamed cervix  

The infected cervix is often tender on movement and is congested with prominent but normal branching blood vessels. Inflammation of the columnar epithelium can give the cervix a beefy-red appearance.

Sometimes staghorn-like small capillaries or prominent vessels are seen on the infected cervix.

Infection with Trichomonas vaginalis may produce a “strawberry” appearance of the cervix because of focal round patches of dilated capillaries on the surface.

An inflamed cervix may have diffuse white patches after application of acetic acid. The white patches are thin with indistinct or irregular margins. Inflamed areas may bleed on contact because the epithelium is thinned out.

Inflammation is followed by repair of the damaged epithelium. During the reparative process, glycogen may be absent from the epithelium. As a result, patchy iodine -negative areas are seen after inflammation.

Application of Lugol’s iodine to an inflamed cervix sometimes produces the typical “leopard-skin” appearance because of multiple iodine-negative spots. Such changes are more commonly seen in trichomoniasis.

Sometimes follicular (chronic) cervicitis is detectable as multiple small raised whitish areas on the squamous epithelium.

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