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Vulval intraepithelial neoplasia — DRCOG MCQ

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HardGynaecological OncologyVulval intraepithelial neoplasiaDRCOG

A 67-year-old woman presents with vulval itching and a thickened white plaque on the labia that has developed an irregular raised area. She has used emollients without improvement. What is the most appropriate management?

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Correct answer: B — Urgent vulval biopsy or suspected cancer referral

A new raised or irregular area within a persistent vulval plaque raises concern for VIN or vulval cancer and needs urgent biopsy or referral. Repeated empirical treatment risks delay. The pearl is that lichen sclerosus-like symptoms still require reassessment when the lesion changes.

Reference: NICE NG12; RCOG vulval cancer guidance