title: Normal findings in vulvar examination and vulvoscopy.
abstract: OBJECTIVE
  To determine the normal vulvar findings by naked eye examination and by vulvoscopy in healthy women without vulvar complaints.
  
  
  METHODS
  Observational study.
  
  
  METHODS
  Forty healthy volunteers without vulvar complaints recruited via a newspaper advertisement.
  
  
  METHODS
  Vulvar examination, human papillomavirus (HPV) polymerase chain reaction of vulvar and cervical swabs, saline and KOH smears and vulvoscopy before and after the application of 5% acetic acid.
  
  
  METHODS
  Prevalence of vestibular erythema, vestibular papillomatosis, HPV infection on the vulva and in the cervix and vulvoscopic findings.
  
  
  RESULTS
  The mean age of the women was 37.8 years (median 38.0, range 21-56). Nine women were current smokers and 21 had previously smoked. Naked eye vulvar examination showed vestibular papillomatosis in 13 women (33%) and vestibular erythema in 17 women (43%). The touch test was positive in 9 of the 17 women (53%) with vestibular erythema. Vulvoscopy after the application of acetic acid 5% showed an acetowhite vestibule in all women. Twelve women (30%) had acetowhite lesions outside the vestibule. Six women (15%) were positive for HPV DNA. The presence of HPV DNA did not correlate with vestibular erythema or vestibular papillomatosis. There was a weak association between HPV DNA and acetowhite lesions outside the vestibule (P = 0.055, Fisher's exact test). In this group the younger women significantly more often had vestibular papillomatosis (t-statistic = 3.07; P = 0.003) and women who smoke more often had a genital HPV infection (P = 0.016, Fisher's exact test).
  
  
  CONCLUSIONS
  Vestibular erythema, vestibular papillomatosis, and acetowhite lesions are common in this group of healthy women without vulvar complaints.
authors.affiliation: Department of Obstetrics and Gynaecology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: van Beurden
authors.forename: N
authors.initials: N
authors.lastname: van der Vange
authors.forename: A J
authors.initials: AJ
authors.lastname: de Craen
authors.forename: S P
authors.initials: SP
authors.lastname: Tjong-A-Hung
authors.forename: F J
authors.initials: FJ
authors.lastname: ten Kate
authors.forename: J
authors.initials: J
authors.lastname: ter Schegget
authors.forename: F B
authors.initials: FB
authors.lastname: Lammes
mesh_terms: D000328:Adult; D003127:Colposcopy; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006558:Herpes Genitalis / Q000473:pathology / Q000821:virology; D006801:Humans; D008875:Middle Aged; D010808:Physical Examination; D012627:Sebaceous Glands / Q000033:anatomy & histology; D018139:Simplexvirus / Q000302:isolation & purification; D014844:Vulva / Q000033:anatomy & histology*; D014845:Vulvar Diseases / Q000473:pathology / Q000821:virology
chemical_list: D004279:DNA, Viral