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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: 118

  • Age: 36

  • Before application of acetic acid: A small trickle of blood is seen close to the external os. No obvious abnormality is seen.

  • Cervix before application of acetic acid:  

  • After application of acetic acid: A large acetowhite area with sharp margins is seen occupying more than 75% of the ectocervix. The abnormal area occupies the entire posterior lip. Acetowhitening is not prominent, because of extensive erosions that bleed on contact.

  • 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:  

  • After application of Lugolís iodine: The lesion appears bright yellow.

  • Determined eligibility for ablative treatment:  

  • Histopathology: HSIL-CIN3

  • Remarks: Large lesions occupying all four quadrants of the cervix are not suitable for treatment by ablative methods. High-grade lesions may have extensive erosions on the surface, and the dense acetowhite areas may not be obvious.





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