Before application of acetic acid: The cervix appears normal.
Cervix before application of acetic acid:
After application of acetic acid: The columnar epithelium appears white temporarily. Thin acetowhite areas with feathery margins are seen at the 11Ė12 oíclock position. Note the tongue-shaped projections towards the external os.
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):
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.