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

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  • Case: 67

  • Age: 34

  • Before application of acetic acid: Red velvety columnar epithelium is seen around the external os. A nabothian cyst is present at the 7 o’clock position.

  • Cervix before application of acetic acid:  
  • Nabothian cyst

    After application of acetic acid: Thin acetowhite areas with indistinct margins are seen on the posterior lip. White patches are also seen on the columnar epithelium on the anterior lip.

  • Cervix after application of acetic acid:
    • Squamocolumnar junction visibility:  
    • Squamocolumnar junction location:  
    • Acetowhite area:  
      • If present, description of acetowhite area:
        • Colour:  
        • Margin:  
        • Surface:  
        • Location:  
        • Size:  

  • VIA category:  

  • Determined eligibility for ablative treatment (if HPV-positive):  

  • Histopathology: Not done

  • Remarks: Transparent acetowhite areas with indistinct margins are suggestive of squamous metaplasia. The appearance may be confusing. When in doubt, a diagnosis of VIA-positive should be given, so that the woman can be further evaluated or treated.





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