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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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VIA-positive cases                                                                              Click to return to the atlas
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  • Case: 121

  • Age: 36

  • Before application of acetic acid: The cervix appears normal. The SCJ is fully visible.

  • Cervix before application of acetic acid:  
  • Nabothian cyst

    After application of acetic acid: A thin acetowhite area with irregular geographical margins is seen in the TZ at the 12–2 o’clock position close to 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:  

  • After application of Lugol’s iodine: The iodine non-uptake area has clearly defined margins.

  • Determined eligibility for ablative treatment:  

  • Histopathology: LSIL-HPV changes

  • Remarks: On VIA, acetowhite areas due to HPV infections cannot be reliably distinguished from low-grade precancers. Where a screen-and-treat protocol is followed, it is advisable to treat such acetowhite areas in the TZ by ablative methods if the lesion fulfils the criteria for ablation.





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