Before application of acetic acid: The external os is covered by mucoid discharge.
Cervix before application of acetic acid:
After application of acetic acid: Acetic acid dissolves the mucus, and the SCJ becomes clearly visible. The ectocervix is covered by pink mature squamous epithelium. No acetowhite area.
After application of acetic acid (magnified view): Crypt openings are seen as tiny openings with a surrounding thin acetowhite border. The islands of columnar epithelium (skip areas) appear as small pockets through which the red columnar epithelium is visible. The features are indicative of metaplasia.
Cervix after application of acetic acid:
Squamocolumnar junction visibility:
Squamocolumnar junction location:
Acetowhite area:
VIA category:
Determined eligibility for ablative treatment (if HPV-positive):
Histopathology: Not done
Remarks: The cervix may not show any features of metaplasia (e.g. no crypt openings or nabothian cysts). An area of a few square millimetres surrounding the SCJ is considered as the transformation zone (TZ). Sometimes the TZ appears pale in colour compared with the mature squamous epithelium surrounding it.