These two conditions, lichen sclerosis and VIN III, can be present for years and be misdiagnosed as yeast infections. The most important point about premalignant vulvar changes is that there is usually a long delay in diagnosis. Often these women are not examined properly or the examiner is unfamiliar with this condition and prescribes yet another course of cream, salve, or ointment. Usually the condition is fully visible and simply needs to be biopsied to establish the diagnosis. There is usually an obvious growth on the skin or an ulcerated area.
Diagnosis is by simple biopsy.
These cancers are usually slow growing and do not spread early. When they do spread it is usually by way of the lymph nodes. The regional lymph nodes are located at the top of the thigh in the groin area. Vulvar cancers are staged by a combination of examination and surgery. The TNM staging system is used.