{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T04:17:41Z","timestamp":1788322661320,"version":"build-2803163510"},"reference-count":29,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T00:00:00Z","timestamp":1630540800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Applying Lugol\u2019s iodine solution to the cervix followed by colposcopic assessment is an established standard test to identify low grade\/high grade squamous intraepithelial lesions (LSIL\/HSIL). Here, we assessed the performance of Lugol\u2019s iodine test during colposcopy using a standardized protocol with 5% acetic acid followed by 5% Lugol\u2019s iodine solution and recording the most severe acetowhite (MSAWL) and iodine-negative (MSINL) lesions in a prospective cohort of consecutive women referred to our specialized colposcopy unit. The primary study endpoint was the sensitivity\/specificity of MSINL for the detection of LSIL\/HSIL. Secondary endpoints were the time to first appearance of the MSINL, MSINL staining intensity, and fading of MSINL. Three hundred and twenty women were included. The sensitivity and specificity of MSINL for the detection of LSIL\/HSIL was 81.4 (95%\u2014confidence interval (CI) 77.3\u201385.0)% and 29.5 (24.2\u201335.5)%, respectively. Ninety-six MSINL were identified exclusively by Lugol\u2019s iodine test (no pathology, n = 46; LSIL, n = 29; HSIL, n = 21) (number needed to biopsy to identify one additional LSIL\/HSIL = 1.9). In 17\/320 (5.3%) patients, the clinical management was changed based on the result of Lugol\u2019s iodine test. Video analysis showed an instant appearance of the MSINL within 10 s in 100% of cases. Intensity of MSINL significantly correlated with the presence\/absence of LSIL\/HSIL (Spearman rank order correlation; p &lt; 0.0001). Fading of iodine-induced staining intensity over time was not observed. Thus, Lugol\u2019s iodine showed moderate sensitivity and poor specificity, but changed clinical management in 5% of cases when used in addition to acetic acid.<\/jats:p>","DOI":"10.3390\/diagnostics11091598","type":"journal-article","created":{"date-parts":[[2021,9,2]],"date-time":"2021-09-02T10:02:11Z","timestamp":1630576931000},"page":"1598","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Sequential Application of Lugol\u2019s Iodine Test after Acetic Acid for Detecting Cervical Dysplasia: A Prospective Cohort Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0852-6002","authenticated-orcid":false,"given":"G\u00fcnther A.","family":"Rezniczek","sequence":"first","affiliation":[{"name":"Department of Obstetrics and Gynecology, Marien Hospital Herne, Ruhr-Universit\u00e4t Bochum, 44625 Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samira","family":"Ertan","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Marien Hospital Herne, Ruhr-Universit\u00e4t Bochum, 44625 Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadia","family":"Rehman","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Marien Hospital Herne, Ruhr-Universit\u00e4t Bochum, 44625 Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6904-3258","authenticated-orcid":false,"given":"Clemens B.","family":"Tempfer","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Marien Hospital Herne, Ruhr-Universit\u00e4t Bochum, 44625 Herne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,2]]},"reference":[{"key":"ref_1","unstructured":"Jain, M.A., and Limaiem, F. 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