Colposcopy with acetic acid may help delineate areas of VIN and make biopsy easier. VIN may be asymptomatic and can come to the attention of a patient's health care provider during an annual examination. Pruritus, however, may be present, as well as a burning sensation of the vulva. Biopsy of any white, red, or dark lesion is prudent, particularly in the older patient. Progression from VIN to cancer is uncommon in younger women, but more likely in older patients.
Diagnosis is by biopsy, with colposcopy and acetic acid application.
Multiple areas may need biopsy. The risk for progression to cancer is actually low for VIN, particularly in younger patients, but treatment is still necessary prevent patients from disease progression. These lesions may be covered by a nonadherent, oily scale. Pruritus and the finding of similar extraovular lesions increases suspicion, and biopsy make the diagnosis. Seborrheic dermatitis may mimic chronic candida, psoriasis, contact dermatitis, and, if focal, VIN, although this is usually a generalized disorder of the vulva.