Treatment of Differentiated-Type Vulvar Intraepithelial Neoplasia (dVIN)
Differentiated-type vulvar intraepithelial neoplasia is a distinct subtype of VIN. Because of its clinical behaviour and risk profile, it requires a specific and well-defined management approach.
Clinical Scenario
This protocol applies to patients with confirmed differentiated-type vulvar intraepithelial neoplasia (dVIN). The subtype designation directly determines the treatment strategy — excisional management is always required for this form of VIN.
Treatment Approach
Management centres on a conservative surgical approach directed at visible lesions, with attention to achieving adequate margins. Medical treatments and ablative modalities are not appropriate for this subtype. When certain associated dermatological conditions are present, targeted topical therapy may also be incorporated.
The complete protocol — including procedural details, margin requirements, management of associated conditions, and follow-up — is available via the link below.
References
- For differentiated vulvar intraepithelial neoplasia (dVIN), an excisional procedure must always be adopted.
- dVIN complete surgical excision of visible lesions is recommended to treat the lesion and to exclude invasive disease.
- Because of the risk of progression to invasive vulvar squamous cell carcinoma from dVIN with a short interval, there is no role for medical treatment or ablation of dVIN, and therapy is conservative excision with negative surgical margins followed by continuous follow-up.
- After dVIN excision, treatment of associated Lichen sclerosus and Lichen Planus with topical high potency corticosteroids is recommended to reduce the risk of recurrence/progression.
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