Atlas of visual inspection of the cervix with acetic acid for screening, triage, and assessment for treatment

A cervical condyloma or genital wart is a benign condition caused by infection with low-risk HPV types. A condyloma appears as a distinct grey-white or snow-white raised area on the cervix. The surface of a condyloma can be irregular, pitted, or even spiky. A condyloma may be located within or outside the TZ. A cervical condyloma may be accompanied by similar lesions in the vulva and the vagina. Condylomata by themselves do not progress to malignancy.

Sometimes a cervical condyloma may become visible or more prominent after application of acetic acid. Such a condyloma appears as a flat white patch with a sharp but irregular margin and may be located within or outside the TZ. The density of acetowhitening may be thin or dense. The lesion has an angular or irregular margin. Such geographical margins of the lesion make it look like an island in the ocean.

Quite often the condylomata are multiple, and they may be located within and outside the TZ. In the presence of multiple white areas, lesions that are detached from the SCJ are known as satellite lesions.

Sometimes the condylomata may be densely white after application of acetic acid and present as a thick opaque lesion raised from the surface. It becomes very difficult to distinguish them from high-grade CIN lesions.

The next section discusses the growths and ulcers seen on the cervix before application of acetic acid.