Lasers in Medical Science

, Volume 1, Issue 3, pp 175–180 | Cite as

Condylomatous ulcerative lesions in the vulva and introitus: Association with concomitant koilocytotic lesions in the vagina and cervix; effect of carbon dioxide laser vaporization

  • E. Rubinstein


The association of condylomatous ulcerative lesions in the vulva with concomitant koilocytotic lesions in the vagina and cervix indicates the existence of a ‘lower genital tract neoplasia syndrome’. In this study of 54 young women, 90% of the patients with condylomatous lesions in the vulva and introitus had similar concomitant lesions in the lower third of the vagina; 7% had lesions in the upper third; and 13% had lesions in the anus. Furthermore, 80% of the women exhibited koilocytotic, non-neoplastic lesions in the cervix or koilocytotic intraepithelial neoplasia. It has been shown previously that patients with concomitant human papilloma virus infection and cervical intraepithelial neoplasia are younger than patients with cervical intraepithelial neoplasia alone, and that in the former group the lesions are acquired and progress at a faster rate. Epithelial integrity may be an important barrier to viral transmission, and diseases that cause mucosal or squamous epithelial discontinuity are risk factors for acquired immunodeficiency syndrome (AIDS) virus infection. Therefore, to limit the spread of this serious disease, all genital lesions should be treated without delay. Carbon dioxide laser vaporization of cervical and vaginal lesions gives excellent results; laser surgery of vulval lesions, however, creates considerable practical problems.

Key words

Human papilloma virus Koilocytotic lesions Carbon dioxide laser Cervix Vagina Vulva AIDS 


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  1. 1.
    Koss LG, Durfee GR. Unusual patterns of squamous epithelium of the uterine cervix; cytology and pathologic study of koilocytotic atypia.Ann NY Acad Sci 1956,63:1–245Google Scholar
  2. 2.
    Rubinstein E. Probably virus-induced epithelial lesions in preinvasive cervical cancer.Acta Obstet Gynecol Scand 1980,59:529–35PubMedGoogle Scholar
  3. 3.
    Rubinstein E, Strale J-E. The invasive potency of dysplasia with koilocytotic atypia.Acta Obstet Gynecol Scand 1983,62:381–3PubMedCrossRefGoogle Scholar
  4. 4.
    Kreiss JK, Koech D, Plummer FA et al. AIDS virus infection in Nairobi prostitutes.N Engl J Med 1986,314:414–8PubMedCrossRefGoogle Scholar
  5. 5.
    Evan-Jones JC, Forbes-Smith PA, Hirschowitz L. Follow-up of women with cervical koilocytosis.Lancet 1985, i:1445CrossRefGoogle Scholar
  6. 6.
    Roberts PF, Carron Brown J. Condylomatous atypia of the endometrial cavity. Case report.Br J Obstet Gynaecol 1985.92:535–8PubMedGoogle Scholar
  7. 7.
    Rubinstein E. CO2-laser vaporization for chronic koilocytotic cervicitis: A multifocal disease. Fourth Annual Conference of British Medical Laser Association. 1986, January 22–23, LondonGoogle Scholar
  8. 8.
    Rubinstein E. Koilocytotic metaplasia and intraepithelial neoplasia of the uterine cervix. Treatment with CO2-laser surgery.Acta Obstet Gynecol Scand Suppl 1984,125:25–31CrossRefGoogle Scholar
  9. 9.
    Crum CP, Egawa K, Fu YS et al. Atypical immature metaplasia (AIM). A subset of HPV infection of the cervix.Cancer (Phila) 1983,51:2214–9Google Scholar
  10. 10.
    Papanicolaou GN, Traut HF.Diagnosis of uterine cancer by the vaginal smear. New York: Comm Fund, 1943Google Scholar
  11. 11.
    Reid R, Laverty CR, Coppleson M et al. Non-condylomatous cervical wart virus infection.Obstet Gynecol 1980,55:476–83PubMedGoogle Scholar
  12. 12.
    Meisels A, Morin C, Casas-Cordero M. Human papillomavirus infection of the uterine cervix.Int J Gynecol Pathol 1982,1:75–82PubMedCrossRefGoogle Scholar
  13. 13.
    Boon ME, Fox CH. Simultaneous condyloma acuminatum and dysplasia of the uterine cervix.Acta Cytol 1981,25:393–403PubMedGoogle Scholar
  14. 14.
    Crum CP, Egawa K, Barron B et al. Human papilloma-virus infection (condyloma) of the cervix and cervical intraepithelial neoplasia: A histological and statistical analysis.Gynecol Oncol 1983,15:88–97CrossRefPubMedGoogle Scholar
  15. 15.
    Winkler B, Richart RM. The histology of CIN, VIN and VAIN. In: Baggish MS (ed)Basic and Advanced Laser Surgery. Norwalk: Appleton-Century-Crofts, 1985Google Scholar

Copyright information

© Baillière Tindall 1986

Authors and Affiliations

  • E. Rubinstein
    • 1
  1. 1.Colposcopy and Laser Research UnitUppsalaSweden

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