What causes vulvar dysplasia (VIN) and cancer — is HPV involved?
More than one infectious agent has been suspected as the cause of vulvar dysplasia. Herpes simplex virus, granulomatous STD infections, and human papilloma virus have all been shown to be associated. In fact 80%-90% of all VIN has been shown to have HPV DNA present. Interestingly, only 30-50% of invasive vulvar cancers have been shown to have HPV DNA in them. Some experts have postulated that patients with squamous cancers of the vulva can be divided into two groups that may have different causes for their cancers. Younger women (35-55) tend to have cancers associated with HPV infection and VIN. The lesions are usually multifocal over various areas of the vulva. Older women (55-85) have more of a history of vulvar inflammation, itching and burning for many years and lichen sclerosis, a whitening skin change. Their cancers are usually unifocal and do not show evidence of HPV infection or vulvar intraepithelial neoplasia changes in the surrounding tissue. How likely is it for vulvar intr
