[Colposcopy of the vulva]

A detailed colposcopy study of the cervix, vagina and vulva was conducted in 365 women referred for genital human papillomavirus (HPV) lesions, abnormal cervico-vaginal smear or cervical intraepithelial neoplasia (CIN). Valvuloscopic abnormalities, all biopsied, were found in 144 women, i.e. 40% of the population studied. Five types of vulvoscopic abnormalities are described: diffuse acidophilia (55% of abnormalities), acidophilic maculae (17%), micropapillae (20%), papulae (4%) and leucoparakeratosis (4%). Histological examination of the biopsy specimens obtained from 144 women with abnormal vulvoscopy showed 55 typical flat condylomas (38%), 50 probable flat condylomas (35%) and no signs of condyloma in 38 cases (27%). It also revealed the presence of four vulvar intraepithelial neoplasias (VIN) stages 2-3, all of them associated with typical or probable condyloma. Comparison between the 144 abnormal vulvoscopies and a series of 14 normal vulvoscopies made it possible to establish a significant correlation between the presence of valvuloscopic abnormalities and the finding of histological signs of typical or probable flat condyloma. The vulvoscopic images of subclinical vulvar HPV infection, but apart from papulae and, to a lesser extent, leucoparakeratosis, correlations between vulvoscopic and histological images were imprecise.