Before application of acetic acid: Nabothian cysts are present at the 8 o’clock and 3 o’clock positions.
Cervix before application of acetic acid:
After application of acetic acid: The SCJ is fully visible. The outer limit of the TZ can be delineated by the location of the farthest nabothian cyst. A tongue-shaped thin acetowhite area at the 12 o’clock position is seen projecting 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):
Histopathology: Not done
Remarks: The columnar epithelium is gradually being replaced by transparent metaplastic epithelium with tongue-shaped advancing edges projecting towards the external os. Metaplasia is the most common cause of false-positive VIA, especially in young women. Note that the acetowhite area of metaplasia does not have any outer margin.