Vulvar Intraepithelial Neoplasia (VIN)

Vulvar intraepithelial neoplasia, or VIN, is a precancerous skin condition on the vulva. It occurs when there are changes in the cells of the skin covering the vulva. VIN is not cancer. However, if the changes become more severe, cancer of the vulva may develop after many years. Also known as dysplasia, VIN can range from mild to severe.

The exact cause is not known, however it has been linked to:

• Human papillomavirus (HPV), a common infection
• Herpes simplex virus
• Granuloma inguinale, a sexually transmitted disease (STD)
• Smoking
• Immunosuppression
• Chronic vulvar irritation

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
• Pain during sex

In rare cases, there may be no symptoms initially.

Diagnosis may include:

• A physical exam
• A colposcopy, an office procedure that uses a special microscope (colposcope) to closely examine the tissue for abnormal areas
• A biopsy of the affected area. A local anesthetic is given to numb the area. A small sample of vulva tissue is then taken and the cells are examined under a microscope.

Lifestyle habits that may help prevent VIN or detect it early include:

• Practicing safe sex
• Vaccinating girls with the HPV vaccine before their first sexual contact
• Regular exams for early detection and treatment, preventing cancer of the vulva from developing

Treatment varies depending on how abnormal the skin cells are, the size of the affected area, and the estimated risk of the area developing into vulvar cancer. Treatment options 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

VIN can recur after treatment, therefore regular follow-up appointments are highly recommended.