This protocol covers management of high-grade squamous intraepithelial lesion (HSIL), usual-type vulvar intraepithelial neoplasia (VIN), in patients with confirmed HPV-related disease where occult invasion has been excluded.
HSIL (usual-type VIN), HPV-related; occult invasion ruled out; not pregnant; not immunosuppressed. In this setting, the absence of occult invasion and the HPV-related aetiology open a range of management options — from topical and ablative approaches to excision — depending on lesion characteristics. Ablative or topical therapies may be used in HSIL (usual-type VIN) after occult invasion has been ruled out, including for unifocal or multifocal isolated lesions.
When residual or persistent lesions are present, a surgical approach is among the interventions addressed by this protocol. The full structured regimen covers the complete selection criteria, sequencing, and all applicable management options.