Before application of acetic acid: Scanty thin curdy white discharge is present on the cervix. Note that a red patch around the external os is not always columnar epithelium. Wait until after application of acetic acid before trying to locate the SCJ.
Cervix before application of acetic acid:
Infective vaginal discharge: Strawberry appearance of cervix Cervicitis Polyp Bleeding on contact White patch Growth Ulcer Erosion
After application of acetic acid: Large dense acetowhite areas are seen around the external os occupying more than 75% of the ectocervix. The acetowhite areas extend into the endocervical canal. The SCJ is not visible. Multiple areas of peeled-off epithelium (at the 10, 12, and 6 oíclock positions) can be seen as red patches within the dense acetowhite lesion.
Cervix after application of acetic acid:
Squamocolumnar junction visibility:
Squamocolumnar junction location:
If present, description of acetowhite area:
After application of Lugolís iodine: The acetowhite area does not take up Lugolís iodine and appears bright mustard yellow.
Determined eligibility for ablative treatment:
Remarks: A high-grade lesion may appear as a red patch in the transformation zone on visual examination. This may give a false interpretation of visualization of the SCJ. Always try to identify and locate the SCJ after application of acetic acid.