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:
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:
If present, description of acetowhite area:
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.