{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T20:23:55Z","timestamp":1775247835795,"version":"3.50.1"},"reference-count":199,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T00:00:00Z","timestamp":1655769600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["J Low Genit Tract Dis"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD), and the European Federation for Colposcopy (EFC) developed consensus statements on pre-invasive vulvar lesions in order to improve the quality of care for patients with vulvar squamous intraepithelial neoplasia, vulvar Paget disease in situ, and melanoma in situ. For differentiated vulvar intraepithelial neoplasia (dVIN), an excisional procedure must always be adopted. For vulvar high-grade squamous intraepithelial lesion (VHSIL), both excisional procedures and ablative ones can be used. The latter can be considered for anatomy and function preservation and must be preceded by several representative biopsies to exclude malignancy. Medical treatment (imiquimod or cidofovir) can be considered for VHSIL. Recent studies favor an approach of using imiquimod in vulvar Paget\u2019s disease. Surgery must take into consideration that the extension of the disease is usually wider than what is evident in the skin. A 2 cm margin is usually considered necessary. A wide local excision with 1 cm free surgical margins is recommended for melanoma in situ. Following treatment of pre-invasive vulvar lesions, women should be seen on a regular basis for careful clinical assessment, including biopsy of any suspicious area. Follow-up should be modulated according to the risk of recurrence (type of lesion, patient age and immunological conditions, other associated lower genital tract lesions).<\/jats:p>","DOI":"10.1097\/lgt.0000000000000683","type":"journal-article","created":{"date-parts":[[2022,6,21]],"date-time":"2022-06-21T12:06:54Z","timestamp":1655813214000},"page":"229-244","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":35,"title":["The European Society of Gynaecological Oncology (ESGO), the International Society for the Study of Vulvovaginal Disease (ISSVD), the European College for the Study of Vulval Disease (ECSVD) and the European Federation for Colposcopy (EFC) Consensus Statements on Pre-invasive Vulvar Lesions"],"prefix":"10.1097","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1573-3114","authenticated-orcid":false,"given":"Mario","family":"Preti","sequence":"first","affiliation":[{"name":"Department of Surgical Sciences, University of Torino, Torino, Italy"}]},{"given":"Elmar","family":"Joura","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Gynecologic Oncology, Comprehensive Cancer; Center, Medical University of Vienna, Vienna, Austria"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5335-6770","authenticated-orcid":false,"given":"Pedro","family":"Vieira-Baptista","sequence":"additional","affiliation":[{"name":"Hospital Lusiadas Porto, Porto, Portugal; Lower Genital Tract Unit, Centro Hospitalar de S\u00e3o Jo\u00e3o, Porto, Portugal"}]},{"given":"Marc","family":"Van Beurden","sequence":"additional","affiliation":[{"name":"Centre for Gynecological Oncology Amsterdam, Netherlands Cancer Institute\/Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands"}]},{"given":"Federica","family":"Bevilacqua","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, University of Torino, Torino, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9610-8064","authenticated-orcid":false,"given":"Maaike C. G.","family":"Bleeker","sequence":"additional","affiliation":[{"name":"Department of Pathology, Amsterdam UMC, Vrije Universiteit Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1932-5270","authenticated-orcid":false,"given":"Jacob","family":"Bornstein","sequence":"additional","affiliation":[{"name":"Galilee Medical Center and Azrieli Faculty of Medicine, Bar-Ilan, Israel"}]},{"given":"Xavier","family":"Carcopino","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology, H\u00f4pital Nord, APHM, Aix-Marseille University (AMU), Univ Avignon, CNRS, IRD, IMBE UMR 7263, 13397, Marseille, France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0119-3695","authenticated-orcid":false,"given":"Cyrus","family":"Chargari","sequence":"additional","affiliation":[{"name":"Radiation Therapy, Gustave Roussy Cancer Campus, Paris, France"}]},{"given":"Margaret E.","family":"Cruickshank","sequence":"additional","affiliation":[{"name":"Aberdeen Centre for Women\u2019s Health Research, University of Aberdeen, Aberdeen, United Kingdom"}]},{"given":"Bilal Emre","family":"Erzeneoglu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University, Ankara, Turkey"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3041-1201","authenticated-orcid":false,"given":"Niccol\u00f2","family":"Gallio","sequence":"additional","affiliation":[{"name":"Department of Surgical Sciences, University of Torino, Torino, Italy"}]},{"given":"Debra","family":"Heller","sequence":"additional","affiliation":[{"name":"Rutgers New Jersey Medical School, Newark, NJ"}]},{"given":"Vesna","family":"Kesic","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, University of Belgrade, Belgrade, Serbia"}]},{"given":"Olaf","family":"Reich","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Medical University of Graz, Graz, Austria"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0074-3261","authenticated-orcid":false,"given":"Colleen K.","family":"Stockdale","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, University of Iowa, Iowa City, IA"}]},{"given":"Bilal Esat","family":"Temiz","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Obstetrics and Gynecology, Division of Gynaecological Oncology, Hacettepe University, Ankara, Turkey"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9578-3049","authenticated-orcid":false,"given":"Linn","family":"Woelber","sequence":"additional","affiliation":[{"name":"Department of Gynecology, Hamburg-Eppendorf University Medical Center, Dysplasia Center Hamburg, Jerusalem Hospital, Hamburg, Germany"}]},{"given":"Fran\u00e7ois","family":"Planchamp","sequence":"additional","affiliation":[{"name":"Clinical Research Unit, Institut Bergonie, Bordeaux, France"}]},{"given":"Jana","family":"Zodzika","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology R\u012bga Stradi\u0146\u0161 university, Riga, Latvia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3984-4812","authenticated-orcid":false,"given":"Denis","family":"Querleu","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecologic Oncology, University Hospital, Strasbourg, France; Division of Gynecologic Oncology, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4221-4459","authenticated-orcid":false,"given":"Murat","family":"Gultekin","sequence":"additional","affiliation":[{"name":"Division of Gynaecological Oncology, Department of Obstetrics and Gynaecology, Hacettepe University Faculty of Medicine, Ankara, Turkey"}]}],"member":"276","published-online":{"date-parts":[[2022,6,21]]},"reference":[{"key":"bib1-20250926","first-page":"973","article-title":"Report of the ISSVD terminology committee","volume":"31","year":"1986","journal-title":"J Reprod Med Obstet Gynecol"},{"key":"bib2-20250926","first-page":"807","article-title":"Squamous vulvar intraepithelial neoplasia: 2004 modified terminology, ISSVD vulvar oncology subcommittee","volume":"50","year":"2005","journal-title":"J Reprod Med"},{"key":"bib3-20250926","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1097\/LGT.0b013e31825c31dd","article-title":"The lower anogenital squamous terminology standardization project for HPV-associated lesions: background and consensus recommendations from the College of American Pathologists and the American Society for Colposcopy and Cervical Pathology","volume":"16","year":"2012","journal-title":"J Low Genit Tract Dis"},{"key":"bib5-20250926","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1097\/LGT.0000000000000169","article-title":"The 2015 International Society for the Study of Vulvovaginal Disease (ISSVD) terminology of vulvar squamous intraepithelial lesions","volume":"20","year":"2016","journal-title":"J Low Genit Tract Dis"},{"key":"bib8-20250926","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1053\/hupa.2002.124788","article-title":"Vulvar Paget disease of urothelial origin: a report of three cases and a proposed classification of vulvar Paget disease","volume":"33","year":"2002","journal-title":"Hum Pathol"},{"key":"bib9-20250926","doi-asserted-by":"crossref","first-page":"2105","DOI":"10.1245\/s10434-018-6513-7","article-title":"Melanoma staging: American Joint Committee on Cancer (AJCC) 8th edition and beyond","volume":"25","year":"2018","journal-title":"Ann Surg Oncol"},{"key":"bib10-20250926","article-title":"Vulvar intraepithelial neoplasia: classification, epidemiology, diagnosis, and management","volume":"49","year":"2020","journal-title":"J Gynecol Obstet Hum Reprod"},{"key":"bib11-20250926","first-page":"991","article-title":"Incidence et prise en charge des condylomes acumin\u00e9s externes en m\u00e9decine g\u00e9n\u00e9rale","volume":"129","year":"2002","journal-title":"Ann Dermatol Venereol"},{"key":"bib12-20250926","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1016\/j.gyobfe.2006.12.010","article-title":"Incidence, prise en charge et co\u00fbt des condylomes acumin\u00e9s anog\u00e9nitaux chez les femmes consultant leur gyn\u00e9cologue en France","volume":"35","year":"2007","journal-title":"Gyn\u00e9cologie Obs Fertil"},{"key":"bib13-20250926","doi-asserted-by":"crossref","first-page":"645","DOI":"10.1016\/j.ygyno.2005.02.012","article-title":"Is the assumed natural history of vulvar intraepithelial neoplasia III based on enough evidence? A systematic review of 3322 published patients","volume":"97","year":"2005","journal-title":"Gynecol Oncol"},{"key":"bib14-20250926","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1097\/01.AOG.0000187301.76283.7f","article-title":"Vulvar intraepithelial neoplasia: aspects of the natural history and outcome in 405 women","volume":"106","year":"2005","journal-title":"Obstet Gynecol"},{"key":"bib15-20250926","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1002\/ijc.33198","article-title":"Vulvar intraepithelial neoplasia: incidence and long-term risk of vulvar squamous cell carcinoma","volume":"148","year":"2021","journal-title":"Int J Cancer"},{"key":"bib16-20250926","doi-asserted-by":"crossref","first-page":"3450","DOI":"10.1016\/j.ejca.2013.06.033","article-title":"Worldwide human papillomavirus genotype attribution in over 2000 cases of intraepithelial and invasive lesions of the vulva","volume":"49","year":"2013","journal-title":"Eur J Cancer"},{"key":"bib17-20250926","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1016\/j.ejca.2008.11.037","article-title":"Vulvar squamous cell carcinoma development after diagnosis of VIN increases with age","volume":"45","year":"2009","journal-title":"Eur J Cancer"},{"key":"bib18-20250926","first-page":"1779","article-title":"Is the incidence of invasive vulvar cancer increasing in the United States?","volume":"20","year":"2009","journal-title":"Cancer Causes Control"},{"key":"bib19-20250926","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1002\/ijc.33185","article-title":"A meta-analysis of anal cancer incidence by risk group: toward a unified anal cancer risk scale","volume":"148","year":"2021","journal-title":"Int J Cancer"},{"key":"bib20-20250926","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1097\/AOG.0b013e31820bfb16","article-title":"Risk of anal cancer in a cohort with human papillomavirus-related gynecologic neoplasm","volume":"117","year":"2011","journal-title":"Obstet Gynecol"},{"key":"bib21-20250926","doi-asserted-by":"crossref","first-page":"214","DOI":"10.1016\/j.ejso.2011.12.008","article-title":"Invasive extramammary Paget\u2019s disease and the risk for secondary tumours in Europe","volume":"38","year":"2012","journal-title":"Eur J Surg Oncol"},{"key":"bib22-20250926","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1016\/j.critrevonc.2016.03.008","article-title":"Paget disease of the vulva","volume":"101","year":"2016","journal-title":"Crit Rev Oncol Hematol"},{"key":"bib23-20250926","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1007\/s10147-011-0325-0","article-title":"Paget's disease of the vulva: a clinicopathologic institutional review","volume":"17","year":"2012","journal-title":"Int J Clin Oncol"},{"key":"bib24-20250926","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1016\/j.ygyno.2012.01.032","article-title":"Treatment outcomes in a large cohort of patients with invasive extramammary Paget's disease","volume":"125","year":"2012","journal-title":"Gynecol Oncol"},{"key":"bib25-20250926","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1136\/ijgc-00009577-200605000-00040","article-title":"Paget's disease of the vulva: clinicopathologic study of type 1 cases treated at a single institution","volume":"16","year":"2006","journal-title":"Int J Gynecol Cancer"},{"key":"bib26-20250926","doi-asserted-by":"crossref","first-page":"166.e7","DOI":"10.1016\/j.urolonc.2015.11.009","article-title":"Primary genitourinary melanoma: epidemiology and disease-specific survival in a large population-based cohort","volume":"34","year":"2016","journal-title":"Urol Oncol"},{"key":"bib27-20250926","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/S1028-4559(09)60281-3","article-title":"Primary malignant melanoma of the female genital tract","volume":"48","year":"2009","journal-title":"Taiwan J Obstet Gynecol"},{"key":"bib28-20250926","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1016\/j.jaad.2020.09.036","article-title":"Melanoma in situ and invasive melanoma of the vulva: an analysis of the National Cancer Database","volume":"84","year":"2021","journal-title":"J Am Acad Dermatol"},{"key":"bib29-20250926","doi-asserted-by":"crossref","first-page":"1118","DOI":"10.1097\/IGC.0b013e3182980ffb","article-title":"Vulvar\/vaginal melanoma: an updated surveillance epidemiology and end results database review, comparison with cutaneous melanoma and significance of racial disparities","volume":"23","year":"2013","journal-title":"Int J Gynecol Cancer"},{"key":"bib30-20250926","doi-asserted-by":"crossref","first-page":"1161","DOI":"10.1002\/ijc.30821","article-title":"Prevalence and type distribution of human papillomavirus in squamous cell carcinoma and intraepithelial neoplasia of the vulva","volume":"141","year":"2017","journal-title":"Int J Cancer"},{"key":"bib31-20250926","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1097\/PAP.0000000000000155","article-title":"Role of human papillomavirus in vulvar cancer","volume":"24","year":"2017","journal-title":"Adv Anat Pathol"},{"key":"bib32-20250926","doi-asserted-by":"crossref","first-page":"2481","DOI":"10.1002\/ijc.33459","article-title":"DNA methylation markers for cancer risk prediction of vulvar intraepithelial neoplasia","volume":"148","year":"2021","journal-title":"Int J Cancer"},{"key":"bib33-20250926","doi-asserted-by":"crossref","first-page":"4542","DOI":"10.1002\/cam4.1633","article-title":"Molecular heterogeneity in human papillomavirus-dependent and -independent vulvar carcinogenesis","volume":"7","year":"2018","journal-title":"Cancer Med"},{"key":"bib34-20250926","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1158\/1055-9965.EPI-16-0019","article-title":"Lichen sclerosus: incidence and risk of vulvar squamous cell carcinoma","volume":"25","year":"2016","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"bib35-20250926","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1111\/his.12034","article-title":"Pathways of vulvar intraepithelial neoplasia and squamous cell carcinoma","volume":"62","year":"2013","journal-title":"Histopathology"},{"key":"bib36-20250926","doi-asserted-by":"crossref","first-page":"6781","DOI":"10.1158\/1078-0432.CCR-17-1302","article-title":"Genomic characterization of vulvar (pre)cancers identifies distinct molecular subtypes with prognostic significance","volume":"23","year":"2017","journal-title":"Clin Cancer Res"},{"key":"bib37-20250926","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1038\/modpathol.2016.187","article-title":"Differentiated exophytic vulvar intraepithelial lesions are genetically distinct from keratinizing squamous cell carcinomas and contain mutations in PIK3CA","volume":"30","year":"2017","journal-title":"Mod Pathol"},{"key":"bib38-20250926","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1038\/s41379-020-0524-1","article-title":"Major p53 immunohistochemical patterns in in situ and invasive squamous cell carcinomas of the vulva and correlation with TP53 mutation status","volume":"33","year":"2020","journal-title":"Mod Pathol"},{"key":"bib39-20250926","first-page":"1","article-title":"Inflammatory proteins HMGA2 and PRTN3 as drivers of vulvar squamous cell carcinoma progression","volume":"13","year":"2021","journal-title":"Cancers"},{"key":"bib40-20250926","first-page":"291","article-title":"Squamous precursor lesions of the vulva: current classification and diagnostic challenges","volume":"48","year":"2016","journal-title":"Pathology"},{"key":"bib41-20250926","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1016\/j.jaad.2014.05.057","article-title":"Vulvar cancers in women with vulvar lichen planus: a clinicopathological study","volume":"71","year":"2014","journal-title":"J Am Acad Dermatol"},{"key":"bib42-20250926","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1002\/ijc.31025","article-title":"Cancer risk of lichen planus: a cohort study of 13,100 women in Finland","volume":"142","year":"2018","journal-title":"Int J Cancer"},{"key":"bib43-20250926","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1111\/j.1365-2133.1994.tb04987.x","article-title":"Squamous cell carcinoma arising in vulval lichen planus","volume":"131","year":"1994","journal-title":"Br J Dermatol"},{"key":"bib44-20250926","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1111\/j.1365-2230.1996.tb00117.x","article-title":"The under-reporting of skin disease in association with squamous cell carcinoma of the vulva","volume":"21","year":"1996","journal-title":"Clin Exp Dermatol"},{"key":"bib45-20250926","first-page":"665","article-title":"Vulval lichen planus: progression of pseudoepitheliomatous hyperplasia to invasive vulval carcinomas","volume":"108","year":"2001","journal-title":"BJOG"},{"key":"bib46-20250926","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1046\/j.1365-2133.2000.03891.x","article-title":"A clinical study of 23 cases of female anogenital carcinoma","volume":"143","year":"2000","journal-title":"Br J Dermatol"},{"key":"bib47-20250926","doi-asserted-by":"crossref","first-page":"1035","DOI":"10.1016\/S0002-9440(10)64924-3","article-title":"Monoclonal \u03b3-T-cell receptor rearrangement in vulvar lichen sclerosus and squamous cell carcinomas","volume":"160","year":"2002","journal-title":"Am J Pathol"},{"key":"bib48-20250926","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1111\/j.1365-2559.2006.02405.x","article-title":"Extramammary Paget\u2019s disease-a proliferation of adnexal origin?","volume":"48","year":"2006","journal-title":"Histopathology"},{"key":"bib49-20250926","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1038\/modpathol.3800243","article-title":"p185HER2 overexpression and HER2 oncogene amplification in recurrent vulvar Paget's disease","volume":"18","year":"2005","journal-title":"Mod Pathol"},{"key":"bib50-20250926","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1007\/s00404-007-0434-1","article-title":"COX-2 and Her-2\/neu are overexpressed in Paget\u2019s disease of the vulva and the breast: results of a preliminary study","volume":"277","year":"2008","journal-title":"Arch Gynecol Obstet"},{"key":"bib51-20250926","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1111\/his.13239","article-title":"Molecular subtyping of mammary-like adenocarcinoma of the vulva shows molecular similarity to breast carcinomas","volume":"71","year":"2017","journal-title":"Histopathology"},{"key":"bib52-20250926","doi-asserted-by":"crossref","first-page":"2211","DOI":"10.1007\/s00432-019-02975-3","article-title":"The vulvar immunohistochemical panel (VIP) project: molecular profiles of vulvar Paget's disease","volume":"145","year":"2019","journal-title":"J Cancer Res Clin Oncol"},{"key":"bib53-20250926","doi-asserted-by":"crossref","first-page":"824","DOI":"10.1002\/ijc.27738","article-title":"Oncogenic mutations in extramammary Paget's disease and their clinical relevance","volume":"132","year":"2013","journal-title":"Int J Cancer"},{"key":"bib54-20250926","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1097\/DAD.0000000000000725","article-title":"Study of selected BRCA1, BRCA2, and PIK3CA mutations in benign and malignant lesions of anogenital mammary-like glands","volume":"39","year":"2017","journal-title":"Am J Dermatopathol"},{"key":"bib55-20250926","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1111\/j.1365-2133.2005.06589.x","article-title":"Comparative genomic hybridization in extramammary Paget\u2019s disease","volume":"153","year":"2005","journal-title":"Br J Dermatol"},{"key":"bib56-20250926","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1016\/j.ygyno.2018.04.562","article-title":"Melanoma of the lower genital tract: prognostic factors and treatment modalities","volume":"150","year":"2018","journal-title":"Gynecol Oncol"},{"key":"bib57-20250926","first-page":"531","article-title":"VIN usual type-from the past to the future","volume":"9","year":"2015","journal-title":"Ecancermedicalscience"},{"key":"bib58-20250926","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1111\/j.1471-0528.1997.tb11461.x","article-title":"Normal findings in vulvar examination and vulvoscopy","volume":"104","year":"1997","journal-title":"Br J Obstet Gynaecol"},{"key":"bib59-20250926","article-title":"Recommendations favoring anal cytology as a method for anal cancer screening: a systematic review","volume":"11","year":"2019","journal-title":"Cancers"},{"key":"bib60-20250926","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1016\/j.bpobgyn.2014.07.010","article-title":"Vulvar intraepithelial neoplasia","volume":"28","year":"2014","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"bib61-20250926","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1097\/00004347-200101000-00003","article-title":"Vulvar intraepithelial neoplasia: historical aspects and current status","volume":"20","year":"2001","journal-title":"Int J Gynecol Pathol"},{"key":"bib62-20250926","doi-asserted-by":"crossref","first-page":"768","DOI":"10.5858\/arpa.2018-0019-RS","article-title":"Differentiated vulvar intraepithelial neoplasia: a brief review of clinicopathologic features","volume":"143","year":"2019","journal-title":"Arch Pathol Lab Med"},{"key":"bib63-20250926","doi-asserted-by":"crossref","first-page":"e27","DOI":"10.3802\/jgo.2017.28.e27","article-title":"Risk factors for unrecognized invasive carcinoma in patients with vulvar high-grade squamous intraepithelial lesion at vulvoscopy-directed biopsy","volume":"28","year":"2017","journal-title":"J Gynecol Oncol"},{"key":"bib64-20250926","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.bpobgyn.2005.11.001","article-title":"Vulval cancer: prevention and screening","volume":"20","year":"2006","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"bib65-20250926","first-page":"339","article-title":"ISSVD terminology and classification of vulvar dermatological disorders: an approach to clinical diagnosis","volume":"2012","year":"2011","journal-title":"J Low Genit Tract Dis"},{"key":"bib66-20250926","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1097\/00128360-200304000-00009","article-title":"Vulvar Paget disease: one century after first reported","volume":"7","year":"2003","journal-title":"J Low Genit Tract Dis"},{"key":"bib67-20250926","doi-asserted-by":"crossref","first-page":"741","DOI":"10.3109\/00016341003739575","article-title":"Premalignant epithelial disorders of the vulva: squamous vulvar intraepithelial neoplasia, vulvar Paget\u2019s disease and melanoma in situ","volume":"89","year":"2010","journal-title":"Acta Obstet Gynecol Scand"},{"key":"bib68-20250926","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1016\/S1701-2163(16)34619-9","article-title":"Post-surgical treatment of melanoma in situ of the vulva with imiquimod","volume":"32","year":"2010","journal-title":"J Obstet Gynaecol Can"},{"key":"bib69-20250926","doi-asserted-by":"crossref","first-page":"795","DOI":"10.1016\/j.det.2010.08.007","article-title":"Pigmented lesions of the vulva","volume":"28","year":"2010","journal-title":"Dermatol Clin"},{"key":"bib70-20250926","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1111\/j.1471-0528.2000.tb13298.x","article-title":"Inter-observer variation in histopathological diagnosis and grading of vulvar intraepithelial neoplasia: results of a European collaborative study","volume":"107","year":"2000","journal-title":"BJOG"},{"key":"bib71-20250926","article-title":"Histological interpretation of differentiated vulvar intraepithelial neoplasia (dVIN) remains challenging\u2014observations from a bi-national ring-study","journal-title":"Virchows Arch"},{"key":"bib72-20250926","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1097\/PAS.0000000000000291","article-title":"Expanding the morphologic spectrum of differentiated VIN (dVIN) through detailed mapping of cases with p53 loss","volume":"39","year":"2015","journal-title":"Am J Surg Pathol"},{"key":"bib73-20250926","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1038\/modpathol.2010.192","article-title":"Differentiated vulvar intraepithelial neoplasia is often found in lesions, previously diagnosed as lichen sclerosus, which have progressed to vulvar squamous cell carcinoma","volume":"24","year":"2011","journal-title":"Mod Pathol"},{"key":"bib74-20250926","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1097\/LGT.0000000000000572","article-title":"Diagnostic criteria for differentiated vulvar intraepithelial neoplasia and vulvar aberrant maturation","volume":"25","year":"2021","journal-title":"J Low Genit Tract Dis"},{"key":"bib75-20250926","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1097\/LGT.0000000000000532","article-title":"Clinicopathologic diagnostic criteria for vulvar lichen planus","volume":"24","year":"2020","journal-title":"J Low Genit Tract Dis"},{"key":"bib76-20250926","doi-asserted-by":"crossref","first-page":"102866","DOI":"10.1016\/j.critrevonc.2020.102866","article-title":"Precursor lesions of vulvar squamous cell carcinoma \u2013 histology and biomarkers: a systematic review","volume":"147","year":"2020","journal-title":"Crit Rev Oncol Hematol"},{"key":"bib77-20250926","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1053\/j.semdp.2020.09.007","article-title":"Extramammary Paget disease of the vulva","volume":"38","year":"2021","journal-title":"Semin Diagn Pathol"},{"key":"bib78-20250926","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1053\/hupa.2002.124787","article-title":"Uroplakin-III to distinguish primary vulvar Paget disease from Paget disease secondary to urothelial carcinoma","volume":"33","year":"2002","journal-title":"Hum Pathol"},{"key":"bib79-20250926","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s13000-020-00952-w","article-title":"Perianal Paget\u2019s disease: a clinicopathological and immunohistochemical study of 13 cases","volume":"15","year":"2020","journal-title":"Diagn Pathol"},{"key":"bib80-20250926","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.anndiagpath.2016.07.010","article-title":"Diagnostic utility of epithelial and melanocitic markers with double sequential immunohistochemical staining in differentiating melanoma in situ from invasive melanoma","volume":"26","year":"2017","journal-title":"Ann Diagn Pathol"},{"key":"bib81-20250926","doi-asserted-by":"crossref","first-page":"2831","DOI":"10.1002\/ijc.25302","article-title":"Imiquimod-induced clearance of HPV is associated with normalization of immune cell counts in usual type vulvar intraepithelial neoplasia","volume":"127","year":"2010","journal-title":"Int J Cancer"},{"key":"bib82-20250926","doi-asserted-by":"crossref","first-page":"6617","DOI":"10.1158\/0008-5472.CAN-08-0327","article-title":"Disturbed patterns of immunocompetent cells in usual-type vulvar intraepithelial neoplasia","volume":"68","year":"2008","journal-title":"Cancer Res"},{"key":"bib83-20250926","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1016\/j.ygyno.2006.01.036","article-title":"Antigen processing and correlation with immunological response in vulval intraepithelial neoplasia\u2013a study of CD1a, CD54 and LN3 expression","volume":"102","year":"2006","journal-title":"Gynecol Oncol"},{"key":"bib84-20250926","first-page":"E85","article-title":"Intraepithelial macrophage infiltration is related to a high number of regulatory T cells and promotes a progressive course of HPV-induced vulvar neoplasia","volume":"136","year":"2015","journal-title":"Int J Cancer"},{"key":"bib85-20250926","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1038\/nm934","article-title":"Evidence for a tumoral immune resistance mechanism based on tryptophan degradation by indoleamine 2,3-dioxygenase","volume":"9","year":"2003","journal-title":"Nat Med"},{"key":"bib86-20250926","first-page":"192","article-title":"Immunological and viral factors associated with the response of vulval intraepithelial neoplasia to photodynamic therapy","volume":"61","year":"2001","journal-title":"Cancer Res"},{"key":"bib87-20250926","doi-asserted-by":"crossref","first-page":"1223","DOI":"10.1080\/14712598.2018.1542426","article-title":"The immune microenvironment in vulvar (pre)cancer: review of literature and implications for immunotherapy","volume":"18","year":"2018","journal-title":"Expert Opin Biol Ther"},{"key":"bib88-20250926","doi-asserted-by":"crossref","first-page":"1838","DOI":"10.1056\/NEJMoa0810097","article-title":"Vaccination against HPV-16 oncoproteins for vulvar intraepithelial neoplasia","volume":"361","year":"2009","journal-title":"N Engl J Med"},{"key":"bib89-20250926","doi-asserted-by":"crossref","first-page":"2342","DOI":"10.1158\/1078-0432.CCR-15-2594","article-title":"Vaccination against oncoproteins of HPV16 for noninvasive vulvar\/vaginal lesions: lesion clearance is related to the strength of the T-cell response","volume":"22","year":"2016","journal-title":"Clin Cancer Res"},{"key":"bib90-20250926","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.ygyno.2010.10.019","article-title":"FOXP3+ regulatory T-cells are abundant in vulvar Paget\u2019s disease and are associated with recurrence","volume":"120","year":"2011","journal-title":"Gynecol Oncol"},{"key":"bib91-20250926","doi-asserted-by":"crossref","first-page":"625","DOI":"10.2340\/00015555-1453","article-title":"Comparison of Foxp3+ regulatory T cells and CD163+ macrophages in invasive and non-invasive extramammary Paget's disease","volume":"92","year":"2012","journal-title":"Acta Derm Venereol"},{"key":"bib92-20250926","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1016\/j.ygyno.2018.09.026","article-title":"The immune cell infiltrate in the microenvironment of vulvar Paget disease","volume":"151","year":"2018","journal-title":"Gynecol Oncol"},{"key":"bib93-20250926","article-title":"Medical and surgical interventions for the treatment of usual-type vulval intraepithelial neoplasia","volume":"2016","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"key":"bib94-20250926","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1001\/jamadermatol.2020.1074","article-title":"Association of topical corticosteroids with reduced vulvar squamous cell carcinoma recurrence in patients with vulvar lichen sclerosus","volume":"156","year":"2020","journal-title":"JAMA Dermatol"},{"key":"bib95-20250926","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1016\/j.ygyno.2017.11.006","article-title":"Prognostic factors for local recurrence of squamous cell carcinoma of the vulva: a systematic review","volume":"148","year":"2018","journal-title":"Gynecol Oncol"},{"key":"bib96-20250926","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/j.ygyno.2016.06.019","article-title":"Adjacent lichen sclerosis predicts local recurrence and second field tumour in women with vulvar squamous cell carcinoma","volume":"142","year":"2016","journal-title":"Gynecol Oncol"},{"key":"bib97-20250926","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1001\/jamadermatol.2015.0643","article-title":"Long-term management of adult vulvar lichen sclerosus: a prospective cohort study of 507 women","volume":"151","year":"2015","journal-title":"JAMA Dermatol"},{"key":"bib98-20250926","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1097\/PGP.0000000000000280","article-title":"The natural history of vulvar intraepithelial neoplasia, differentiated type: evidence for progression and diagnostic challenges","volume":"35","year":"2016","journal-title":"Int J Gynecol Pathol"},{"key":"bib99-20250926","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/j.ygyno.2011.07.010","article-title":"Residual anogenital lichen sclerosus after cancer surgery has a high risk for recurrence: a clinicopathological study of 75 women","volume":"123","year":"2011","journal-title":"Gynecol Oncol"},{"key":"bib100-20250926","doi-asserted-by":"crossref","first-page":"97","DOI":"10.1016\/j.ejogrb.2007.02.009","article-title":"Vulvar intraepithelial neoplasia\u2013the need for auditable measures of management","volume":"137","year":"2008","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"bib101-20250926","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1097\/QAD.0000000000000984","article-title":"Vulvar intraepithelial neoplasia: clinical presentation, management and outcomes in women infected with HIV","volume":"30","year":"2016","journal-title":"Aids"},{"key":"bib102-20250926","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.ijgo.2007.03.023","article-title":"HPV-related vulvar intraepithelial neoplasia: outcome of different management modalities","volume":"99","year":"2007","journal-title":"Int J Gynecol Obstet"},{"key":"bib103-20250926","doi-asserted-by":"crossref","first-page":"236","DOI":"10.3802\/jgo.2013.24.3.236","article-title":"Disease progression and recurrence in women treated for vulvovaginal intraepithelial neoplasia","volume":"24","year":"2013","journal-title":"J Gynecol Oncol"},{"key":"bib104-20250926","first-page":"CR532","article-title":"The re-infection rate of high-risk HPV and the recurrence rate of vulvar intraepithelial neoplasia (VIN) usual type after surgical treatment","volume":"17","year":"2011","journal-title":"Med Sci Monit"},{"key":"bib105-20250926","first-page":"2949","article-title":"Adjuvant topical treatment with imiquimod 5% after excisional surgery for VIN 2\/3","volume":"18","year":"2014","journal-title":"Eur Rev Med Pharmacol Sci"},{"key":"bib106-20250926","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1016\/j.ygyno.2005.08.012","article-title":"Evaluation of different treatment modalities for vulvar intraepithelial neoplasia (VIN): CO(2) laser vaporization, photodynamic therapy, excision and vulvectomy","volume":"100","year":"2006","journal-title":"Gynecol Oncol"},{"key":"bib107-20250926","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1097\/LGT.0b013e318196bd23","article-title":"Vulvar intraepithelial neoplasia 3 in women less than 35 years","volume":"13","year":"2009","journal-title":"J Low Genit Tract Dis"},{"key":"bib108-20250926","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/j.ygyno.2013.06.006","article-title":"The use of argon beam coagulation in treating vulvar intraepithelial neoplasia III: a retrospective review","volume":"131","year":"2013","journal-title":"Gynecol Oncol"},{"key":"bib109-20250926","doi-asserted-by":"crossref","first-page":"446","DOI":"10.1097\/LGT.0b013e318284c1ed","article-title":"Treatment of vulvar intraepithelial neoplasia with CO(2) laser vaporization and excision surgery","volume":"17","year":"2013","journal-title":"J Low Genit Tract Dis"},{"key":"bib110-20250926","doi-asserted-by":"crossref","first-page":"831","DOI":"10.1097\/AOG.0b013e31821a0f4d","article-title":"Genital warts and vulvar intraepithelial neoplasia: natural history and effects of treatment and human immunodeficiency virus infection","volume":"118","year":"2011","journal-title":"Obstet Gynecol"},{"key":"bib111-20250926","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1006\/gyno.2001.6577","article-title":"Vulvar intraepithelial neoplasia treated with cavitational ultrasonic surgical aspiration","volume":"85","year":"2002","journal-title":"Gynecol Oncol"},{"key":"bib112-20250926","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1097\/PGP.0b013e3181a934d4","article-title":"Accuracy of preoperative vulva biopsy and the outcome of surgery in vulvar intraepithelial neoplasia 2 and 3","volume":"28","year":"2009","journal-title":"Int J Gynecol Pathol"},{"key":"bib113-20250926","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1097\/LGT.0b013e3182410544","article-title":"Vulvar intraepithelial neoplasia: evaluation of treatment modalities","volume":"16","year":"2012","journal-title":"J Low Genit Tract Dis"},{"key":"bib114-20250926","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.ygyno.2017.10.029","article-title":"Vulvar intraepithelial neoplasia: risk factors for recurrence","volume":"148","year":"2018","journal-title":"Gynecol Oncol"},{"key":"bib115-20250926","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1111\/j.0004-8666.2002.00075.x","article-title":"High-grade vulval intraepithelial neoplasia (VIN 3): a retrospective analysis of patient characteristics, management, outcome and relationship to squamous cell carcinoma of the vulva 1989-1999","volume":"42","year":"2002","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"bib116-20250926","doi-asserted-by":"crossref","first-page":"1476","DOI":"10.1097\/IGC.0b013e3182a57fd6","article-title":"Clinical characteristics associated with development of recurrence and progression in usual-type vulvar intraepithelial neoplasia","volume":"23","year":"2013","journal-title":"Int J Gynecol Cancer"},{"key":"bib117-20250926","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1097\/00128360-200210000-00008","article-title":"Loop electrosurgical excision procedure in vulvar intraepithelial neoplasia treatment","volume":"6","year":"2002","journal-title":"J Low Genit Tract Dis"},{"key":"bib118-20250926","doi-asserted-by":"crossref","first-page":"942","DOI":"10.1097\/01.AOG.0000258783.49564.5c","article-title":"Surgical treatments for vulvar and vaginal dysplasia: a randomized controlled trial","volume":"109","year":"2007","journal-title":"Obstet Gynecol"},{"key":"bib119-20250926","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.ygyno.2012.07.118","article-title":"Vulvar intraepithelial neoplasia (VIN 2\/3): comparing clinical outcomes and evaluating risk factors for recurrence","volume":"127","year":"2012","journal-title":"Gynecol Oncol"},{"key":"bib120-20250926","doi-asserted-by":"crossref","first-page":"784","DOI":"10.3760\/cma.j.issn.0366-6999.20131816","article-title":"Surgical treatment of usual type vulvar intraepithelial neoplasia: a study at three academic hospitals","volume":"127","year":"2014","journal-title":"Chin Med J"},{"key":"bib121-20250926","doi-asserted-by":"crossref","first-page":"780","DOI":"10.1136\/ijgc-00009577-200603000-00049","article-title":"Contemporary experience with the management of vulval intraepithelial neoplasia in Northern Ireland","volume":"16","year":"2006","journal-title":"Int J Gynecol Cancer"},{"key":"bib122-20250926","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1016\/j.ygyno.2015.08.018","article-title":"Imiquimod in cervical, vaginal and vulvar intraepithelial neoplasia: a review","volume":"139","year":"2015","journal-title":"Gynecol Oncol"},{"key":"bib123-20250926","first-page":"701","article-title":"Imiquimod in the treatment of multifocal vulvar intraepithelial neoplasia 2\/3. Results of a pilot study","volume":"47","year":"2002","journal-title":"J Reprod Med"},{"key":"bib124-20250926","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.ygyno.2007.06.003","article-title":"Topical imiquimod can reverse vulvar intraepithelial neoplasia: a randomised, double-blinded study","volume":"107","year":"2007","journal-title":"Gynecol Oncol"},{"key":"bib125-20250926","doi-asserted-by":"crossref","first-page":"1465","DOI":"10.1056\/NEJMoa072685","article-title":"Treatment of vulvar intraepithelial neoplasia with topical imiquimod","volume":"358","year":"2008","journal-title":"N Engl J Med"},{"key":"bib126-20250926","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.ygyno.2010.12.340","article-title":"Treatment of vulvar intraepithelial neoplasia with topical imiquimod: seven years median follow-up of a randomized clinical trial","volume":"121","year":"2011","journal-title":"Gynecol Oncol"},{"key":"bib127-20250926","doi-asserted-by":"crossref","first-page":"1361","DOI":"10.1016\/S1470-2045(14)70456-5","article-title":"Activity, safety, and feasibility of cidofovir and imiquimod for treatment of vulval intraepithelial neoplasia (RT3VIN): a multicentre, open-label, randomised, phase 2 trial","volume":"15","year":"2014","journal-title":"Lancet Oncol"},{"key":"bib128-20250926","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1111\/1471-0528.15124","article-title":"Recurrence of vulval intraepithelial neoplasia following treatment with cidofovir or imiquimod: results from a multicentre, randomised, phase II trial (RT3VIN)","volume":"125","year":"2018","journal-title":"BJOG"},{"key":"bib129-20250926","doi-asserted-by":"crossref","first-page":"5460","DOI":"10.1158\/1078-0432.CCR-17-0040","article-title":"Human papillomavirus DNA methylation predicts response to treatment using cidofovir and imiquimod in vulval intraepithelial neoplasia 3","volume":"23","year":"2017","journal-title":"Clin Cancer Res"},{"key":"bib130-20250926","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.ijgo.2012.09.020","article-title":"Treatment of vulvar intraepithelial neoplasia with topical 5% imiquimod cream","volume":"120","year":"2013","journal-title":"Int J Gynecol Obstet"},{"key":"bib131-20250926","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1016\/j.ygyno.2007.05.019","article-title":"Final results of a phase 2 study using continuous 5% imiquimod cream application in the primary treatment of high-grade vulva intraepithelial neoplasia","volume":"106","year":"2007","journal-title":"Gynecol Oncol"},{"key":"bib132-20250926","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1002\/lsm.10048","article-title":"Photodynamic therapy of vulvar and vaginal condyloma and intraepithelial neoplasia using topically applied 5-aminolevulinic acid","volume":"30","year":"2002","journal-title":"Lasers Surg Med"},{"key":"bib133-20250926","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.pdpdt.2009.03.004","article-title":"Clinical and immunohistochemical assessment of vulval intraepithelial neoplasia following photodynamic therapy using a novel bioadhesive patch-type system loaded with 5-aminolevulinic acid","volume":"6","year":"2009","journal-title":"Photodiagnosis Photodyn Ther"},{"key":"bib134-20250926","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.ygyno.2005.12.015","article-title":"Re: \u2018Is the assumed natural history of vulvar intraepithelial neoplasia III based on enough evidence? A systematic review of 3322 published patients.\u2019","volume":"101","year":"2006","journal-title":"Gynecol Oncol"},{"key":"bib135-20250926","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/j.ygyno.2019.07.017","article-title":"Risk of cervical and vaginal dysplasia after surgery for vulvar intraepithelial neoplasia or cancer: a 6 year follow-up study","volume":"155","year":"2019","journal-title":"Gynecol Oncol"},{"key":"bib136-20250926","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.ejogrb.2006.04.011","article-title":"Management of multicentric lesions of the lower genital tract","volume":"132","year":"2007","journal-title":"Eur J Obstet Gynecol Reprod Biol"},{"key":"bib137-20250926","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1097\/LGT.0000000000000321","article-title":"Yield of cytology surveillance after high-grade vulvar intraepithelial neoplasia or cancer","volume":"21","year":"2017","journal-title":"J Low Genit Tract Dis"},{"key":"bib138-20250926","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1016\/j.ygyno.2013.02.029","article-title":"Primary extramammary Paget\u2019s disease of the vulva: the clinicopathological features and treatment outcomes in a series of 43 patients","volume":"129","year":"2013","journal-title":"Gynecol Oncol"},{"key":"bib139-20250926","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1097\/LGT.0b013e31826569a9","article-title":"Vulvar Paget disease: a large single-centre experience on clinical presentation, surgical treatment, and long-term outcomes","volume":"17","year":"2013","journal-title":"J Low Genit Tract Dis"},{"key":"bib140-20250926","doi-asserted-by":"crossref","first-page":"547","DOI":"10.1016\/j.ygyno.2006.09.017","article-title":"The outcomes of patients with positive margins after excision for intraepithelial Paget\u2019s disease of the vulva","volume":"104","year":"2007","journal-title":"Gynecol Oncol"},{"key":"bib141-20250926","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1097\/LGT.0b013e3182a64a58","article-title":"Clinicopathologic study of vulvar Paget\u2019s disease in China","volume":"18","year":"2014","journal-title":"J Low Genit Tract Dis"},{"key":"bib142-20250926","doi-asserted-by":"crossref","first-page":"176","DOI":"10.1097\/igc.0000000000001131","article-title":"Invasive Paget disease of the vulva","volume":"28","year":"2018","journal-title":"Int J Gynecol Cancer"},{"key":"bib143-20250926","doi-asserted-by":"crossref","first-page":"e178","DOI":"10.2196\/resprot.7503","article-title":"The Paget trial: a multicenter, observational cohort intervention study for the clinical efficacy, safety, and immunological response of topical 5% imiquimod cream for vulvar Paget disease","volume":"6","year":"2017","journal-title":"JMIR Res Protoc"},{"key":"bib144-20250926","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1097\/LGT.0000000000000053","article-title":"Treatment of primary vulvar Paget disease with 5% imiquimod cream","volume":"18","year":"2014","journal-title":"J Low Genit Tract Dis"},{"key":"bib145-20250926","doi-asserted-by":"crossref","first-page":"90","DOI":"10.1016\/j.ygyno.2013.04.008","article-title":"Photodynamic therapy with M-ALA as non surgical treatment option in patients with primary extramammary Paget's disease","volume":"130","year":"2013","journal-title":"Gynecol Oncol"},{"key":"bib146-20250926","first-page":"628","article-title":"Recurrent primary vulvovaginal malignant melanoma arising in melanoma in situ the natural history of lesions followed for 23 years","volume":"14","year":"2004","journal-title":"Int J Gynecol Cancer"},{"key":"bib147-20250926","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1002\/(SICI)1097-0142(19960301)77:5<888::AID-CNCR12>3.0.CO;2-#","article-title":"Clinical diagnosis and therapy of cutaneous melanoma in situ","volume":"77","year":"1996","journal-title":"Cancer"},{"key":"bib148-20250926","doi-asserted-by":"crossref","first-page":"784","DOI":"10.3892\/ijmm.2014.1659","article-title":"A clinicopathological review of 33 patients with vulvar melanoma identifies c-kit as a prognostic marker","volume":"33","year":"2014","journal-title":"Int J Mol Med"},{"key":"bib149-20250926","doi-asserted-by":"crossref","first-page":"2771","DOI":"10.1001\/jama.292.22.2771","article-title":"Early diagnosis of cutaneous melanoma: revisiting the ABCD criteria","volume":"292","year":"2004","journal-title":"JAMA"},{"key":"bib150-20250926","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1016\/j.jaad.2008.05.027","article-title":"Biopsy of the pigmented lesion\u2014when and how","volume":"59","year":"2008","journal-title":"J Am Acad Dermatol"},{"key":"bib151-20250926","doi-asserted-by":"crossref","first-page":"1243","DOI":"10.1097\/AOG.0b013e31817578ba","article-title":"ACOG practice Bulletin No. 93: diagnosis and management of vulvar skin disorders","volume":"111","year":"2008","journal-title":"Obstet Gynecol"},{"key":"bib152-20250926","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1016\/j.ygyno.2011.04.007","article-title":"Malignant melanoma of the vulva: an extension of cutaneous melanoma?","volume":"122","year":"2011","journal-title":"Gynecol Oncol"},{"key":"bib153-20250926","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1097\/AOG.0000000000002736","article-title":"Human papillomavirus genotypes from vaginal and vulvar intraepithelial neoplasia in females 15-26 years of age","volume":"132","year":"2018","journal-title":"Obstet Gynecol"},{"key":"bib154-20250926","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.ygyno.2019.03.253","article-title":"Nine-valent HPV vaccine efficacy against related diseases and definitive therapy: comparison with historic placebo population","volume":"154","year":"2019","journal-title":"Gynecol Oncol"},{"key":"bib155-20250926","doi-asserted-by":"crossref","first-page":"1693","DOI":"10.1016\/S0140-6736(07)60777-6","article-title":"Efficacy of a quadrivalent prophylactic human papillomavirus (types 6, 11, 16, and 18) L1 virus-like-particle vaccine against high-grade vulval and vaginal lesions: a combined analysis of three randomised clinical trials","volume":"369","year":"2007","journal-title":"Lancet"},{"key":"bib156-20250926","doi-asserted-by":"crossref","first-page":"e1401","DOI":"10.1136\/bmj.e1401","article-title":"Effect of the human papillomavirus (HPV) quadrivalent vaccine in a subgroup of women with cervical and vulvar disease: retrospective pooled analysis of trial data","volume":"344","year":"2012","journal-title":"BMJ"},{"key":"bib157-20250926","article-title":"Surgical treatment of vulvar HSIL: adjuvant HPV vaccine reduces recurrent disease","volume":"9","year":"2021","journal-title":"Vaccines"},{"key":"bib158-20250926","doi-asserted-by":"crossref","first-page":"180","DOI":"10.1097\/LGT.0000000000000186","article-title":"Vulvar lichen sclerosus and neoplastic transformation: a retrospective study of 976 cases","volume":"20","year":"2016","journal-title":"J Low Genit Tract Dis"},{"key":"bib159-20250926","first-page":"1069","article-title":"Risk of vulvar carcinoma in women affected with lichen sclerosus: results of a cohort study","volume":"17","year":"2019","journal-title":"JDDG J Ger Soc Dermatology"},{"key":"bib160-20250926","doi-asserted-by":"crossref","first-page":"839","DOI":"10.1111\/bjd.16241","article-title":"British Association of Dermatologists guidelines for the management of lichen sclerosus, 2018","volume":"178","year":"2018","journal-title":"Br J Dermatol"},{"key":"bib161-20250926","doi-asserted-by":"crossref","first-page":"1429","DOI":"10.1007\/s00431-017-3004-y","article-title":"Genital lichen sclerosus in childhood and adolescence-a retrospective case series of 15 patients: early diagnosis is crucial to avoid long-term sequelae","volume":"176","year":"2017","journal-title":"Eur J Pediatr"},{"key":"bib162-20250926","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1007\/s11904-014-0254-4","article-title":"Human papillomavirus in the HIV-infected host: epidemiology and pathogenesis in the antiretroviral era","volume":"12","year":"2015","journal-title":"Curr HIV\/AIDS Rep"},{"key":"bib163-20250926","doi-asserted-by":"crossref","first-page":"903","DOI":"10.2217\/fvl.13.69","article-title":"HPV and HIV coinfection: a complex interaction resulting in epidemiological, clinical and therapeutic implications","volume":"8","year":"2013","journal-title":"Future Virol"},{"key":"bib164-20250926","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1016\/j.ajog.2019.02.022","article-title":"Gynecologic cancer in HIV-positive women: a systematic review and meta-analysis","volume":"221","year":"2019","journal-title":"Am J Obstet Gynecol"},{"key":"bib165-20250926","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1159\/000500469","article-title":"The impact of focality and centricity on vulvar intraepithelial neoplasia on disease progression in HIV+ patients: a 10-year retrospective study","volume":"235","year":"2019","journal-title":"Dermatology"},{"key":"bib166-20250926","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/S0140-6736(02)07368-3","article-title":"HIV-1 infection and risk of vulvovaginal and perianal condylomata acuminata and intraepithelial neoplasia: a prospective cohort study","volume":"359","year":"2002","journal-title":"Lancet"},{"key":"bib167-20250926","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.1177\/0956462415611513","article-title":"Usual vulval intraepithelial neoplasia in HIV-positive women \u2013 a case series","volume":"27","year":"2016","journal-title":"Int J STD AIDS"},{"key":"bib168-20250926","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1093\/infdis\/jit181","article-title":"Evaluation of HIV and highly active antiretroviral therapy on the natural history of human papillomavirus infection and cervical cytopathologic findings in HIV-positive and high-risk HIV-negative women","volume":"208","year":"2013","journal-title":"J Infect Dis"},{"key":"bib169-20250926","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1016\/j.ajog.2003.12.037","article-title":"Effect of antiretroviral therapy on the incidence of genital warts and vulvar neoplasia among women with the human immunodeficiency virus","volume":"190","year":"2004","journal-title":"Am J Obstet Gynecol"},{"key":"bib170-20250926","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1097\/QAI.0b013e318282a189","article-title":"Trends and predictors of non-AIDS-defining cancers in men and women with HIV infection: a single-institution retrospective study before and after the introduction of HAART","volume":"62","year":"2013","journal-title":"J Acquir Immune Defic Syndr"},{"key":"bib171-20250926","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1111\/ajt.14181","article-title":"Reactivation of latent HPV infections after renal transplantation","volume":"17","year":"2017","journal-title":"Am J Transplant"},{"key":"bib172-20250926","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1111\/ajt.13053","article-title":"Cervicovaginal HPV infection in female renal transplant recipients: an observational, self-sampling based, cohort study","volume":"15","year":"2015","journal-title":"Am J Transplant"},{"key":"bib173-20250926","doi-asserted-by":"crossref","first-page":"2413","DOI":"10.1002\/ijc.32565","article-title":"Human papillomavirus-related anogenital premalignancies and cancer in renal transplant recipients: a Danish nationwide, registry-based cohort study","volume":"146","year":"2020","journal-title":"Int J Cancer"},{"key":"bib174-20250926","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/S0140-6736(07)61050-2","article-title":"Incidence of cancers in people with HIV\/AIDS compared with immunosuppressed transplant recipients: a meta-analysis","volume":"370","year":"2007","journal-title":"Lancet"},{"key":"bib175-20250926","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s13027-020-00286-8","article-title":"Role of human papillomavirus infection in the etiology of vulvar cancer in Italian women","volume":"15","year":"2020","journal-title":"Infect Agent Cancer"},{"key":"bib176-20250926","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1097\/TP.0b013e318249b13d","article-title":"Anogenital malignancies in women after renal transplantation over 40 years in a single center","volume":"93","year":"2012","journal-title":"Transplantation"},{"key":"bib177-20250926","doi-asserted-by":"crossref","first-page":"397","DOI":"10.1016\/j.semnephrol.2016.05.016","article-title":"Human papillomavirus in kidney transplant recipients","volume":"36","year":"2016","journal-title":"Semin Nephrol"},{"key":"bib178-20250926","doi-asserted-by":"crossref","first-page":"e13590","DOI":"10.1111\/ctr.13590","article-title":"Human papillomavirus infection in solid organ transplant recipients: guidelines from the American Society of Transplantation infectious diseases community of practice","volume":"33","year":"2019","journal-title":"Clin Transplant"},{"key":"bib179-20250926","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1097\/LGT.0000000000000585","article-title":"Knowledge of vulvar anatomy and self-examination in a sample of Italian women","volume":"25","year":"2021","journal-title":"J Low Genit Tract Dis"},{"key":"bib180-20250926","article-title":"Interventions for enhancing medication adherence","volume":"22","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"key":"bib181-20250926","doi-asserted-by":"crossref","first-page":"269","DOI":"10.1016\/j.ypmed.2017.03.008","article-title":"Medication adherence outcomes of 771 intervention trials: systematic review and meta-analysis","volume":"99","year":"2017","journal-title":"Prev Med"},{"key":"bib182-20250926","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/S1470-2045(08)70147-5","article-title":"Vulvovaginal reconstruction for neoplastic disease","volume":"9","year":"2008","journal-title":"Lancet Oncol"},{"key":"bib183-20250926","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1097\/LGT.0000000000000501","article-title":"The International Society for the Study of Vulvovaginal Disease Surgical Oncological Procedure Definitions Committee \u201cSurgical Terminology for Vulvar Cancer Treatment\u201d","volume":"24","year":"2020","journal-title":"J Low Genit Tract Dis"},{"key":"bib184-20250926","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1016\/j.ygyno.2007.01.027","article-title":"Correlates of sexual function following vulvar excision","volume":"105","year":"2007","journal-title":"Gynecol Oncol"},{"key":"bib185-20250926","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1097\/01.sap.0000141381.77762.07","article-title":"Flap algorithm in vulvar reconstruction after radical, extensive vulvectomy","volume":"54","year":"2005","journal-title":"Ann Plast Surg"},{"key":"bib186-20250926","doi-asserted-by":"crossref","first-page":"1372","DOI":"10.1016\/S0002-9378(97)70078-4","article-title":"Local and distant skin flaps in the reconstruction of vulvar deformities","volume":"177","year":"1997","journal-title":"Am J Obstet Gynecol"},{"key":"bib187-20250926","first-page":"193","article-title":"Plastic management of extensive vulvar defects","volume":"38","year":"1971","journal-title":"Obstet Gynecol"},{"key":"bib188-20250926","first-page":"81","article-title":"Flap repair: an effective strategy for minimising sexual morbidity associated with the surgical management of vulval intra epithelial neoplasia","volume":"45","year":"2000","journal-title":"J R Coll Surg Edinb"},{"key":"bib189-20250926","doi-asserted-by":"crossref","first-page":"443","DOI":"10.2217\/rme-2017-0047","article-title":"Advances in addressing full-thickness skin defects: a review of dermal and epidermal substitutes","volume":"13","year":"2018","journal-title":"Regen Med"},{"key":"bib190-20250926","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1016\/j.bjps.2008.11.073","article-title":"Skinning clitorectomy and skin replacement in women with vulvar intra-epithelial neoplasia","volume":"62","year":"2009","journal-title":"J Plast Reconstr Aesthetic Surg"},{"key":"bib191-20250926","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1016\/0002-9378(68)90508-5","article-title":"Treatment of intraepithelial carcinoma of the vulva by skin excision and graft","volume":"102","year":"1968","journal-title":"Am J Obstet Gynecol"},{"key":"bib192-20250926","first-page":"508","article-title":"Skinning vulvectomy for the treatment of vulvar intraepithelial neoplasia 2-3: a study of 21 cases","volume":"19","year":"1998","journal-title":"Eur J Gynaecol Oncol"},{"key":"bib193-20250926","first-page":"504","article-title":"Partial and total skinning vulvectomy in treatment of carcinoma in situ of the vulva","volume":"68","year":"1986","journal-title":"Obstet Gynecol"},{"key":"bib194-20250926","first-page":"484","article-title":"Skinning vulvectomy for the treatment of multifocal vulvar intraepithelial neoplasia","volume":"69","year":"1987","journal-title":"Obstet Gynecol"},{"key":"bib195-20250926","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1055\/s-0031-1281484","article-title":"Reconstruction of acquired perineovulvar defects: a proposal of sequence","volume":"25","year":"2011","journal-title":"Semin Plast Surg"},{"key":"bib196-20250926","doi-asserted-by":"crossref","first-page":"379","DOI":"10.5999\/aps.2014.41.4.379","article-title":"Subunit principle of vulvar reconstruction: algorithm and outcomes","volume":"41","year":"2014","journal-title":"Arch Plast Surg"},{"key":"bib197-20250926","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1097\/IGC.0000000000000481","article-title":"Vulvar reconstruction by perforator flaps: algorithm for flap choice based on the topography of the defect","volume":"25","year":"2015","journal-title":"Int J Gynecol Cancer"},{"key":"bib198-20250926","doi-asserted-by":"crossref","first-page":"e60","DOI":"10.3802\/jgo.2016.27.e60","article-title":"Surgical therapy of vulvar cancer: how to choose the correct reconstruction?","volume":"27","year":"2016","journal-title":"J Gynecol Oncol"},{"key":"bib199-20250926","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1016\/j.mcna.2018.01.002","article-title":"Clinical examination component of telemedicine, telehealth, mHealth, and connected health medical practices","volume":"102","year":"2018","journal-title":"Med Clin North Am"},{"key":"bib200-20250926","first-page":"248","article-title":"The efficacy of telecolposcopy compared with traditional colposcopy","volume":"99","year":"2002","journal-title":"Obstet Gynecol"},{"key":"bib201-20250926","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/j.ijmedinf.2010.08.006","article-title":"Effectiveness of telemedicine: a systematic review of reviews","volume":"79","year":"2010","journal-title":"Int J Med Inform"},{"key":"bib202-20250926","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1097\/IGC.0000000000000770","article-title":"Perceived health-related quality of life in women with vulvar neoplasia: a cross sectional study","volume":"26","year":"2016","journal-title":"Int J Gynecol Cancer"}],"container-title":["Journal of Lower Genital Tract Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/10.1097\/LGT.0000000000000683","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,26]],"date-time":"2025-09-26T16:02:33Z","timestamp":1758902553000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/10.1097\/LGT.0000000000000683"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,21]]},"references-count":199,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2022]]}},"URL":"https:\/\/doi.org\/10.1097\/lgt.0000000000000683","relation":{},"ISSN":["1526-0976"],"issn-type":[{"value":"1526-0976","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,21]]}}}