Practical tips for assessment and management of vulvar and vaginal human papillomavirus.

Human papillomavirus (HPV) infection has been strongly associated with intraepithelial neoplasia and cancers of the lower genital tract. Due to either better detection or increased incidence of this infection, there is a greater demand for colposcopy. Historically, clinicians have focused their colposcopic investigation on the cervix, often neglecting evaluation of the vulva and vagina. Because HPV is a multicentric disease, these areas should not be overlooked. Nurse colposcopists need to assess and manage women who have HPV-related vulvovaginal lesions that are either symptomatic or have the potential to advance to cancer.