Premalignant vulval conditions

Premalignant vulval conditions are rare, but an evolving disease spectrum must be recognized. There has been an increase in the incidence of human papillomavirus (HPV)-related vulval intraepithelial neoplasia (VIN); the age group of women affected has shifted from post-menopausal women to women in the third and fourth decade. This has led to a change in the terminology and classification of VIN in the past few years. The authors have reviewed these changes, and this contribution describes the aetiology, new terminology, diagnosis and advances in management of VIN, lichen sclerosus and extramammary Paget’s disease.