A2. Vulval intraepithelial neoplasia (VIN)

VIN 3 is most likely a cancer precursor and is induced by infection with high-risk types of HPV. VIN 3 lesions may be asymptomatic or present with itching and/or burning or the appearance of a vulval lesion (often raised and hyperpig-mented), which may be unifocal or multifocal. All vulval lesions should be biopsied to confirm the diagnosis. Treatment options include laser vaporization, excision or cautery. Long term follow up is essential.