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Case: 18
Age: 53
Before application of acetic acid: Atrophic cervix of a woman with uterovaginal prolapse. Multiple red ulcerated areas are seen on both the anterior and posterior lips.
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: The ulcers have sharp margins. The squamous epithelium is atrophic and appears pale pink. The SCJ is not visible. No acetowhite area.
Cervix after application of acetic acid:
Squamocolumnar junction visibility:
Squamocolumnar junction location:
Acetowhite area:
VIA category:
Determined eligibility for ablative treatment (if HPV-positive):
Histopathology: Not done
Remarks: Ulcerations (decubitus ulcers) are caused by venous congestion and friction in women with long-standing uterovaginal prolapse. Thickened squamous epithelium is due to hyperkeratinization, which occurs because of long-standing irritation of the epithelium. The woman should be referred to an appropriate centre for treatment of genital prolapse.