The typical indication of Vulva in different diseases is itching. Patients say that they have extreme itching and complain about the persistence of the itching despite of the different medicines given by different doctors.
Sometimes there can be burning during urination. This is mainly due to clitoris and the lesions holding the urethra. Thus, to the patients with persistent itching at vulva, biopsy should be done. On the other hand there are no indications in 40% of the cases. When tissue is removed from vulva due to different reasons VIN is seen.
In almost half of the patients lesions are rooted in many foci. Therefore, the most ideal is to perform Vulva Colposcopy. Generally the lesions react with the agents used like for example acetic acid. These lesions must be subjected to biopsy. Details of vulvar colposcopy is given in the related section.
The problematic point is that it is sometimes hard to distinguish warts from VIN lesions. Also it is hard to distinguish VIN from invasive cancers of vulva.
Both in gynecological examination and in vulva colposcopy, the vagina and cervix must be assessed for possible lesions (VAIN and CIN) and biopsies should be taken from suspicious lesions.
Patients with persistent itching and detected with visual lesion, problematic tissue should receive vulvar colposcopy and biopsies should be taken from suspicious locations.