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

Role of Lugolís iodine in identifying the transformation zone for treatment Ė Steps for applying Lugolís iodine to the cervix

  

Steps for applying Lugolís iodine to the cervix:

  • After completing the assessment with acetic acid, take a dry cotton swab and wipe out the excess acetic acid solution present on the posterior blade of the speculum.
  • Gently paint the whole cervix with a small cotton swab dipped in 5% Lugolís iodine solution.
  • The colour change is visible immediately; there is no need to wait.
  • The acetowhite area does not take up iodine stain and appears mustard yellow, and the normal squamous epithelium is stained dark brown.
  • Delineate the outer margins of the iodine non-uptake areas, and reassess whether the lesion occupies less than 75% of the ectocervix and can be fully covered by the tip of the largest cryotherapy probe. In thermal ablation, the probe can be applied to the cervix multiple times and the decision is based on the size of the iodine-negative area.
  • The columnar epithelium is not stained with Lugolís iodine and retains its original red colour.







Application of Lugolís iodine should be done after thoroughly completing the assessment with acetic acid, because the iodine stain covers all other features, including acetowhiteness of the epithelium.














































  


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