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References in periodicals archive ?
Grade I-Flat transparent acetowhite epithelium, fine calibre and regular vessels with small intercapillary distance.
Grade II-Flat semi-transparent acetowhite epithelium; vessels with dilated calibre and regular shape, absence of atypical vessels and usually increased intercapillary distances.
Grade III-Opaque acetowhite epithelium, irregularly shaped and dilated vessels with variable intercapillary distance and irregular surface contour.
This procedure allowed identification of changes in the epithelium, characterized as a flat or dense acetowhite epithelium, associated or not with fine or thick punctuation/mosaicism.
Among the 21 patients with abnormal anuscopy, 10 (47.6%) presented low-grade anal lesions, demonstrated by flat acetowhite epithelium, negative iodine or with partial capitation of iodine at the anal squamous-columnar junction, associated or not with a fine mosaic, fine punctuation, micropapillae and concurrent endoanal and perianal condyloma acuminatum.
The main abnormalities associated with high-grade lesions in our patient group were dense acetowhite epithelium associated with thick punctuation or mosaic patterns.
Following 5% acetic acid application, a 2-cm x 3-cm area of acetowhite epithelium was observed in the adjoining region (Figure 2).
The indications for vaginal colposcopy are listed in the Table.[15] The colposcopic appearance of VAIN varies according to the stage of disease.[15] In this case, a high-grade vaginal lesion was expected, based on the dense acetowhite epithelium, coarsely dilated punctation with a wide intercapillary distance, a smooth margin, and multifocal, distinct iodinenegative (a positive Schiller's test result) epithelium.[10] Mosaic vascular patterns are rarely observed in VAIN.[10] An adjoining area of keratosis was also observed by colposcopic examination.
Atrophy ofthe vagina appears slightly iodine negative but no abnormal vascular changes or acetowhite epithelium are visualized.
(%) Examination outcome* Satisfactory colposcopy 228 (84.1) Unsatisfactory colposcopy 43 (15.9) Abnormal colposcopic findings[unkeyable] Acetowhite epithelium 152 (53.9) Punctation 80 (28.3) Mosaic 60 (20.3) Exophytic condyloma 31 (11.0) Leukoplakia 8 (2.8) Atypical vessels 8 (2.8) Polyp(s) 7 (2.5) Erosion 0 (0.0) *Examination outcome was not recorded for 11 patients.
Colposcopists must be able to differentiate atypical squamous metaplasia findings of acetowhite epithelium and fine, closely spaced vascular patterns from the similar characteristics of low-grade disease.
Frequently, the subtle features of high-grade disease are overlooked, especially when positioned within a larger area of prominent acetowhite epithelium typical of low-grade disease.[20] Such an underestimation of severe disease may result in inadequate therapy.