# Unveiling a Dermatological Rarity: The Enigma of Vulvar Intraepithelial Neoplasia Grade III (HSIL) and the Role of p53 in Its Development

## TL;DR

This paper presents a rare case of VIN III, highlighting the role of p53 and the need for ongoing monitoring to prevent cancer.

## Contribution

The case emphasizes the importance of multidisciplinary cooperation in diagnosing VIN III and managing long-term risks.

## Key findings

- VIN III was diagnosed through histological and immunohistochemical analysis showing p16(+) and p53(+).
- Lifelong surveillance is necessary as resecting lesions does not prevent invasive cancer.
- Multidisciplinary cooperation is crucial for effective management of VIN III.

## Abstract

Vulvar intraepithelial neoplasia, also known as VIN, is a non-invasive squamous lesion and precursor of squamous cell carcinoma (SCC) of the vulva. There is no screening test for vulvar intraepithelial neoplasia. Diagnosis of VIN is made clinically and confirmed with a biopsy. We describe a 66-year-old woman with a condyloma-like tumour located in the skin on the vestibule of the vagina. A biopsy sample was taken from the nodule. The definitive diagnosis is supported by the histological examination (VIN III) and immunohistochemical examination of p16(+), p53(+), and a few cell nuclei. The case provides information on the importance of multidisciplinary cooperation. Lifelong surveillance is essential since the resection of individual lesions does not guarantee the prevention of invasive cancer.