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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: 86

  • Age: 33

  • Before application of acetic acid: The cervix appears normal.

  • Cervix before application of acetic acid:  
  • Ectropion

    After application of acetic acid: The columnar epithelium appears white temporarily. Thin acetowhite areas with feathery margins are seen at the 11–12 o’clock position. Note the tongue-shaped projections towards the external os.

  • 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: Normal

  • Remarks: Thin acetowhite areas with feathery margins are suggestive of squamous metaplasia. When in doubt, a VIA-positive diagnosis should be given, so that the woman can be further assessed or treated. It is better to overcall than to miss a high-grade precancer.





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