On colposcopy, aceto-white change is identified at the transformation zone. A thick, dense, white lesion with coarse mosaic vascular pattern and irregular surface contour is seen adjacent to the squamocolumnar junction. The colposcopic feature most predictive of high-grade squamous intraepithelial lesion (HSIL/CIN 2–3) is:

• A Thick, dense (oyster-white) aceto-white change ✓
• B Fine mosaic vascular pattern
• C Aceto-white change that appears slowly and fades quickly
• D Thin, translucent aceto-white change at the periphery

Explanation

Dense (thick, oyster-white or chalk-white), rapidly appearing and slowly fading acetowhiteness is the hallmark of high-grade CIN (CIN 2–3/HSIL) on colposcopy. In low-grade lesions, acetowhitening is thin, faint, and fades quickly. Coarse mosaic or punctation, inner border sign, and ridge sign are additional high-grade features (Reid colposcopic index). Fine mosaic pattern suggests low-grade or subclinical HPV infection. The Swede score and IFCPC 2011 terminology use these features to grade colposcopic findings.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.