An acetowhite color that appears ‘more opaque’ suggests the presence of low-grade SIL.

Colposcopic findings in a 20-year-old gravida 0 not previously vaccinated against HPV. The patient suffers from condylomata acuminata of the vulva. Her cervical smear was reported as class IIID1. HPV 6 and 42 were detected. Colposcopy shows a circular, acetowhite atypical T-zone type 2, which is classified as grade 1 (minor change) abnormal colposcopic finding.

Histopathology of tissue sampled at 6 o’clock by strip biopsy shows atypical squamous epithelium in which the immune marker Ki67 is expressed into the middle third of the epithelium. The marker p16 is detected only focally and at low concentration. The histopathologic diagnosis is grade 1 cervical intraepithelial neoplasia (CIN 1).