Vulvar intraepithelial neoplasia

The presence of human papilloma virus (HPV) is associated with female genital tract diseases such as condyloma, Bowenoid papulosis, and cervical, vaginal, and vulvar intraepithelial neoplasia and carcinoma. A general concern is the association of HPV with cervical cancer (Gl). The HPV consists of an icosahedral viral particle (virion) containing 8000 base pairs, a circular, double-stranded piece of DNA surrounded by a protein capsid. Viral replication takes place within the nuclei of infected squamous epithelial cells (H5). Following infection of epithelial cells, the viral DNA penetrates throughout the entire thickness of the epithelium, but intact viruses are found only in the upper layers of tissue. 

GardasU Four placebo-controUed, double-blind, randomized Phase II and Phase III trials were conducted to evaluate the efficacy. Cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ (AIS), vulvar intraepithelial neoplasia (VIN), and genital warts were used as the surrogate markers. 

The grade of vulvar intraepithelial neoplasia (VIN) can be scored by subclassifying it on the basis of the extent of cellular changes into three types (Van Beurden et al., 1999) ... 

Vulvar intraepithelial neoplasia show a spectrum of pathological alterations, including nuclear pleomorphism, hyperchromasia, altered epithelial maturation, cellular aggregation, loss of normal keratinocyte polarity, and atypical mitotic features (Wilkinson, 1992). 

Muderspach, L., Wilczynski, S., Roman, L., et al. (2000) A phase I trial of a human papillomavirus (HPV) peptide vaccine for women with high-grade cervical and vulvar intraepithelial neoplasia who are HPV 16 positive. Clin. Cancer Res. 6, 3406-3416. 

Pagetoid vulvar intraepithelial neoplasia (VIN) is distinguished by expression of HMWK, pi 6, and p63. 

Yang B, Hart WR. Vulvar intraepithelial neoplasia of the simplex (differentiated) type A clinicopathologic study including analysis of HPV and p53 expression. Am J Surg Pathol. 2000 24 429-241. 

Liegl B, Regauer S. p53 immunostaining in lichen sclerosus is related to ischaemic stress and is not a marker of differentiated vulvar intraepithelial neoplasia (d-VIN). Histopathology. 2006 48 268-274. 

P. Hillemanns, M. Untch, C. Dannecker, R. Baumgartner, H. Stepp, J. Diebold, H. Weingandt, F. Prove, M. Korell (2000). Photodynamic therapy of vulvar intraepithelial neoplasia using 5-aminolevulinic acid. Int. J. Cancer, 85, 649-653. 

The international Society for the Study of Vulvar Disease (ISSVD) introduced a new classification (1989) of vulvar intraepithelial neoplasia (VIN) terminology replacing previously used terms such as Bowen s disease, erythroplasia of Queyrat etc. VIN is a type of precancerous vulvar tissue abnormality. It is no longer considered as a problem of postmenopausal women, but can develop in any age. 

R.W. Jones, J. Baranyai, S. Stables (1997). Trends in squamous cell carcinoma of the vulva the influence of vulvar intraepithelial neoplasia. Obstet. Gynecol, 90(3), 448-452. 

Stier EA, Goldstone SE, Einstein MH, Jay N, Berry ]M, Wnidn T, et al. Safety and efficacy of topical cidofovir to treat high-grade perianal and vulvar intraepithelial neoplasia in HIV-positive men and women. AIDS 2013 27(4) 545-51. 

M.K. Fehr, R. Homung, A. Degen, V.A. Schwarz, D. Fink, U. Haller, P. Wyss (2002). Photodynamic therapy of vulvar and vaginal condyloma and intraepithelial neoplasia using topically applied 5-aminolevulinic acid. Lasers Surg. Med. 30(4), 273-279. 

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