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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: 71

  • Age: 30

  • Before application of acetic acid: Red columnar epithelium covers most of the ectocervix. Pink squamous epithelium is seen at the periphery. Note the light reflections on the cervix.

  • Cervix before application of acetic acid:  
  • Ectropion

    After application of acetic acid: Diffuse acetowhite areas of squamous metaplasia are seen at the 1 oíclock position. Note that the light reflections are still there but have shifted to other locations.

  • 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: In a large ectropion, the squamous epithelium may be barely visible on the ectocervix. Application of acetic acid helps to trace the SCJ better, because it becomes prominently visible as a sharp white line between the squamous epithelium and the columnar epithelium. A bright focusing light may cause reflection of light from the surface of the cervix. This may sometimes be confused with an acetowhite patch. A light reflection will change its position with movement of the cervix, whereas an acetowhite area will be fixed in its location on the cervix.





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