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Präinvasive Erkrankungen der Vulva

Vulväre intraepitheliale Neoplasie (VIN) und M. Paget

Preinvasive vulvar diseases

Vulvar intraepithelial neoplasia (VIN) and vulvar Paget’s disease

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Der Gynäkologe Aims and scope

Zusammenfassung

Die vulväre intraepitheliale Neoplasie (VIN) und der M. Paget sind präinvasive Erkrankungen der Vulva, die sich in vielen Aspekten unterscheiden oder überlappen. Bei gleicher Symptomatik kann auch das klinische Bild sehr ähnlich sein. Die Ätiologie für beide Erkrankungen ist nicht ganz geklärt, nur für einen Teil der VIN-Erkrankungen ist eine persistierende HPV-Infektion ursächlich. Die lokale Exzision steht für beide Veränderungen im Vordergrund, bei VIN zusätzlich die Laserverdampfung. Daneben gibt es einige experimentelle Behandlungsformen von unterschiedlicher Wirksamkeit und Verträglichkeit. VIN und M. Paget, insbesondere Letzterer, neigen stark zum Rezidiv. Daraus ergeben sich Bedeutung und Notwendigkeit einer zuverlässigen klinischen Nachsorge.

Abstract

Vulvar intraepithelial neoplasia (VIN) and vulvar Paget’s disease are preinvasive diseases of the vulva that differ in some aspects and overlap in others. With the same symptomatology, the clinical picture may be very similar, too. The etiology is not quite clear for either disease: Only the so-called usual type of VIN seems to be induced by persistent HPV infection. Local excision is the most prevalent form of therapy, along with laser vaporization for VIN. There are some experimental treatments of various effectiveness and tolerance. Both VIN and vulvar Paget’s disease have a strong tendency to recur; therefore, competent follow-up is necessary.

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  1. I. Frauenklinik, LMU München, Maistr. 11, 80337, München, Deutschland

    R. Kürzl

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Kürzl, R. Präinvasive Erkrankungen der Vulva. Gynäkologe 42, 265–274 (2009). https://doi.org/10.1007/s00129-008-2305-7

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