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High-Grade Vaginal Intraepithelial Lesion (Vaginal Intraepithelial Neoplasia II-III)
D efinition —Human papillomavirus (HPV)–related proliferation of the vaginal mucosa that leads to extensive, full-thickness loss of maturation of the vaginal epithelium.
Clinical Features
Epidemiology
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Patients present at a slightly older age than those with cervical dysplasia, with the majority presenting around 55 to 57 years of age for high-grade VAIN.
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The advanced age is thought to lead to an increased incidence of invasive disease in this population.
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Sixty-five percent of patients with vaginal intraepithelial lesion (VAIL) have concurrent or prior cervical neoplasia.
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HPV is responsible for the majority of lesions, and predisposing factors include previous cervical intraepithelial neoplasia (CIN), history of previous hysterectomy for dysplasia, history of local radiation therapy, and immunosuppression.
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