There weren’t any suspicious areas during the colposcopic examination and wet prep was normal; the FP concluded that this was an ectropion.
This patient’s ectropion was a variation of normal due to her young age and exposure to oral contraceptives. The Pap smear was sent along with screening tests for chlamydia and gonorrhea; all tests came back normal.
Ectropion is common in adolescents, pregnant women, and those taking estrogen-containing contraceptives. In some women, the juvenile type transformation zone persists into adulthood, or is present after trauma or childbirth, and is termed an ectropion. It has a reddish appearance that is similar to granulation tissue. It may contain gland openings, nabothian cysts, and islands of columnar epithelium surrounded by metaplastic squamous epithelium. Although usually asymptomatic, vaginal discharge and postcoital bleeding may occur.
An ectropion may be treated with ablation if significant discharge or postcoital bleeding is present after dysplasia and cancer have been ruled out.
Photo courtesy of EJ Mayeaux, MD. Text for Photo Rounds Friday courtesy of Richard P. Usatine, MD. This case was adapted from: Mayeaux EJ. Colposcopy–normal and noncancerous findings. In: Usatine R, Smith M, Mayeaux EJ, et al, eds. Color Atlas of Family Medicine. 2nd ed. New York, NY: McGraw-Hill; 2013:525-529.
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