title: Colposcopic acetowhitening of vulvar lesion: a validity study.
abstract: OBJECTIVE
  To evaluate the acetowhite changes of the vulva as a predictor for high grade vulvar intraepithelial neoplasia.
  
  
  METHODS
  We performed retrospective analysis from 344 patients referred to our gynecology oncology clinic for genital dysplasia. All patients underwent vulvar colposcopy. Vulvar biopsies were performed for acetowhite changes and visible vulvar lesions such as ulceration, hyperpigmentation, and thickening of the vulvar tissue. High grade vulvar dysplasia was defined as vulvar intraepithelial neoplasia 2 or worse. Results of the vulvar pathology were collected and sensitivity, specificity, negative and positive predictive values.
  
  
  RESULTS
  Of the 344 women who underwent vulvoscopy 241 patients had acetowhite lesions, of whom 89 had true high grade dysplasia. Using colposcopic acetowhite changes as a marker for high grade vulvar dysplasia, the test's sensitivity was 97 %, specificity was 40 %, negative predictive value was 98 %, and the positive predictive value was 37 %.
  
  
  CONCLUSIONS
  Acetowhitening of the vulva has high sensitivity but low specificity as a predictor of high grade vulvar intraepithelial neoplasia. The absence of acetowhite lesion can reassure that high grade vulvar lesion is absent.
authors.affiliation: The West Clinic, 1588 Union Avenue, 38104, Memphis, TN, USA, santoso@westclinic.com.
authors.forename: Joseph T
authors.initials: JT
authors.lastname: Santoso
authors.forename: Wendy
authors.initials: W
authors.lastname: Likes
mesh_terms: D019342:Acetic Acid; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D002278:Carcinoma in Situ / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D003127:Colposcopy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D011247:Pregnancy; D015995:Prevalence; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013714:Tennessee / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D014846:Vulvar Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology
chemical_list: D019342:Acetic Acid