Vulvar intraepithelial neoplasia, or VIN, is a precancerous skin condition on the vulva, according to Baylor Clinic. It occurs when there are changes in the cells of the skin covering the vulva. VIN can develop anywhere on the vulva, said Patient.co.uk.
American Congress of Obstetricians and Gynecologists (ACOG) stated that VIN is an increasingly common problem, particularly among women in their 40s. Macmillan Cancer Support said that although VIN used to be quite rare, it's now being diagnosed more frequently. It can affect women from their 20s onwards.
Vulvar intraepithelial neoplasia is not cancer. Baylor Clinic said, however, if the changes become more severe, vulvar cancer may develop after many years.
The exact cause of VIN is unknown. It has been linked to human papillomavirus (HPV) which is a common infection, herpes simplex virus, granuloma inguinale (a sexually transmitted disease), smoking, immunosuppression, and chronic vulvar irritation, wrote Baylor Clinic.
VIN is classified into three groups.
The first is usual type VIN. Macmillan Cancer Support wrote usual type VIN can be further divided into warty, basaloid and mixed (warty, basaloid) types. ACOG said usual type VIN is commonly associated with human papillomavirus and other HPV persistence risk factors, such as cigarette smoking and immunocompromised status.
The second type is differentiated type VIN. Patient.co.uk said this is much less common than usual type VIN. ACOG continued saying differentiated type VIN usually is not associated with HPV and is more often associated with vulvar dermatologic conditions, such as lichen sclerosus.
Patient.co.uk said the third type, VIN-unclassified type, is rare.
Symptoms vary but may include chronic vulvar itching; burning, tingling or soreness in the vulva area; change in appearance of the affected area, including areas of redness or white, discolored skin; slightly raised skin lesions; some may appear darkened like a mole or freckle; and pain during sex, wrote Baylor Clinic.
In rare cases, there may be no symptoms initially.
If left untreated, VIN may go away by itself. However, said Patient.co.uk, most VIN cases do not go away.
Baylor Clinic listed treatment options to include:
- Steroid cream to reduce inflammation and control symptoms, with close monitoring
- Surgery to remove the abnormal tissue
- Laser therapy to destroy targeted areas of abnormal cells, using a beam of light
- Diathermy, which uses a tiny electrical current to cut out the affected areas
- Topical chemotherapy cream to remove abnormal cells
- Vulvectomy, removal of the whole vulva, in rare cases where the affected areas are very large
ACOG warned that women with VIN should be considered to be at risk of recurrent VIN and vulvar cancer throughout their lifetimes. Baylor Clinic said that regular follow-up appointments are highly recommended.
Sources:
"ACOG - Management of Vulvar Intraepithelial Neoplasia." ACOG - American Congress of Obstetricians and Gynecologists. N.p., n.d. Web. 23 May 2013.
http://www.acog.org/Resources%20And%20Publications/Committee%20Opinions/Committee%20on%20Gynecologic%20Practice/Management%20of%20Vulvar%20Intraepithelial%20Neoplasia.aspx
"Vulval intra-epithelial neoplasia (VIN) - Cancer Information - Macmillan Cancer Support." Cancer care and support charity - Macmillan Cancer Support. N.p., n.d. Web. 23 May 2013.
http://www.macmillan.org.uk/Cancerinformation/Cancertypes/Vulva/Pre-cancerousconditions/Vin.aspx
"The diagnosis of vulval intraepithelial neoplasia - ONA." Oncology Nurse Advisor - ONA. N.p., n.d. Web. 23 May 2013.
http://www.oncologynurseadvisor.com/the-diagnosis-of-vulval-intraepithelial-neoplasia/article/162205/#
"Sexual-Health Symptoms: 6 Times You Must See a Doctor - Redbook." Sex Tips, Marriage Advice, Getting Pregnant, & Online Sweepstakes - Redbook. N.p., n.d. Web. 23 Mar. 2013.
http://www.redbookmag.com/health-wellness/advice/sexual-health-symptoms-yl
"Vulval Intra-epithelial Neoplasia | Health | Patient.co.uk." Health Information and Advice | Medicines Guide | Patient.co.uk. N.p., n.d. Web. 23 May 2013.
http://www.patient.co.uk/health/Vulval-Intra-epithelial-Neoplasia.htm
"Vulvar Intraepithelial Neoplasia (VIN) - Diseases and Conditions - Obstetrics and Gynecology - Baylor Clinic - Houston, Texas." Home - Baylor Clinic : Houston, Texas. N.p., n.d. Web. 23 May 2013.
http://www.baylorclinic.com/services-specialties/obstetrics/conditions/vin.cfm
Reviewed May 23, 2013
by Michele Blacksberg RN
Edited by Jody Smith