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Patient Information: Vulvar - Vaginal Disease
Vaginal Intraepithelial Neoplasia - VIN
What is Vulvar Intraepithelial Neoplasia - VIN?
Vulvar Intraepithelial Neoplasia (VIN) is the presence of abnormal cells in the vulvar skin. It can occur in one area or several areas in the vulvar skin at the same time. It can occur in one area or several areas in the vulvar skin at the same time. VIN occurs in different degrees of severity or stages.
Stage
• VIN I: mildly abnormal changes in the skin cells (mild dysplasia)
• VIN II: moderately abnormal changes in the skin cells (moderate dysplasia)
• VIN III: severely abnormal changes in the skin cells (severe dysplasia)
VIN is a pre-cancerous change in the vulvar skin. This condition IS NOT CANCER. If left untreated it can go away or MAY develop into cancer, although this is a very slow process, usually taking years to develop into cancer.
VIN occurs in women of all ages. At this time, there appears to be an increase in the number of VIN cases seen in younger women. Also, women with fair skin seem to be more prone to developing VIN than women with darker skin. It is not known if VIN is a sexually transmitted problem, but some forms of VIN may be associated with sexual transmission.
What are the signs and symptoms of VIN?
- Mild to severe vulvar itching.
- Mild to severe vulvar burning
- Vulvar skin may appear thickened and white.
- Vulvar skin color that may also appear:
- Pale white
- Pink to red
- Dark brown
How is VIN diagnosed?
Your doctor will carefully examine the vulva. A vinegar solution will be applied to the vulvar skin. This is called an acetic acid wash. This wash will turn any abnormal areas white. A vulvar biopsy of the abnormal white area will be performed. The biopsy will be done at your clinic appointment. The doctor will numb the area with a medication and then remove a small piece of the vulvar skin. The sample of skin is sent to the pathologist to evaluate it for abnormal cells. the results of the biopsy will be available in about 1 week.
What is the cause of VIN?
The exact cause of VIN is unknown. Studies are being done to determine the cause of VIN. The following factors have been associated with VIN:
- HPV Human Papilloma Virus)
- HSV-2 (Herpes simplex Virus - Type 2)
- Smoking
- Immunosuppression
- Chronic vulvar irritation
What is the treatment for VIN?
Treatment may include any of the following:
- Follow the Guidelines for Vulvar Skin Care.
- Topical 1% Fluorouracil Cream (1% 5 FU or 1% Fluroplex)
- How it is used: A thin layer of cream is applied to the area as directed by the doctor.
- How it Works: Removes the abnormal cells of the skin and allows new healthy skin to grow in its place.
- Caution: Use only as directed. This cream may produce burning, irritation, and redness of the skin. If these problems occur, please contact the clinic.
- Interferon Injection
- How it is used: Injections of medication given three times a week for 4 to 6 weeks.
- How it Works: Helps the immune system to fight abnormal cells.
- Caution: May cause fever, headaches, chills, and fatigue.
- Surgery or Laser Therapy
- How it Works: Remove abnormal cells either by surgical removal or with the use of Laser.
- Caution: Used only when other methods have been unable to remove the abnormal cells.
Follow Up Care for VIN?
VIN is a condition that may come back after treatment. For this reason, it is important that you keep your follow-up appointments. At each visit, we may repeat the acetic acid wash. We want you to return to the clinic if your symptoms, such as itching and burning, return. This is to ensure that the VIN has not returned or that you have not developed any other problems such as a yeast infection.
Helpful Hints
- Baling Soda Soaks: Soak in 4-5 tablespoons of baking soda mixed in lukewarm bath water. soak for 10-15 minutes 2 to 3 times a day. If you are using a sitz bath use 1-2 teaspoons of baking soda.
- Apply A and D Ointment frequently
- Stop smoking
Peer Review Status: Internally
Peer Review Date: 2004
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