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Vulval intraepithelial neoplasia: clinical review.

Preinvasive neoplasia ofthe vulva has been recognised for over 75 years, but terminology to describe the disease has been confusing. Vulval carcinoma in situ (CIS) has been variously described as Bowen's disease, erythroplasia of Queryat, carcinoma in situ simplex, bowenoid papulosis, kraurosis vulvae, and leukoplakia.' In 1983 the 3rd international congress of the International Society for the Study of Vulval Disease (ISSVD ) agreed a modified nomenclature for the uniform classification of vulval intraepithelial neoplasia (VIN). This classification grades vulval atypia in a manner similar to that commonly used for intraepithelial neoplasia of the cervix. VIN is thus classified as: (1) squamous (with or without evidence of infection with human papillomavirus (HPV)) (a) VIN I (showing mild atypia); (b)VIN II (moderate atypia); (c) VIN III (severe atypia, CIS); or (2) nonsquamous (a) Paget's disease; (b) melanoma in situ (showing atypical melanotic hyperplasia). The following discussion deals only with squamous cell VIN.