The inability of HPV to undergo tissue culture and cell culture, or to grow in laboratory animals, has created many difficulties in the diagnosis and study of condyloma acuminatum and HPV infection. Nevertheless, after decades of efforts by numerous scholars, a number of clinical and laboratory tests have been explored for use in studies of condyloma acuminatum, subclinical manifestations of condyloma acuminatum, and the diagnosis and differential diagnosis of HPV latent infection. As we all know, the examination of condyloma acuminata is mainly symptom-based, more typical, experienced doctors can clearly diagnose with the eye, but for some less typical or subclinical infection, you can use the vinegar white test. The actual fact is that you can find a lot of people who are not sure if they are going to be able to get a good deal of money. The actual vinegar white test can accurately diagnose condyloma acuminata? The mechanism by which the acetic acid test makes inconspicuous condyloma acuminatum or subclinical manifestations of condyloma acuminatum visible, or makes latent HPV infection visible to the naked eye, is not well understood. One view is that the whitening of the coated tissue after application of acetic acid is the result of protein coagulation, and that this coagulated protein reflects the abnormal cellular and cellular overgrowth characteristic of HPV-infected epithelium. Another view is that the keratin protein of HPV-infected keratinocytes is different from that of normal uninfected keratinocytes, and that only HPV-infected keratinocytes can be whitened by acetic acid. Test method First, remove the contaminants (or secretions) from the suspected damage site or test site. Then a cotton swab dipped in 3%-5% acetic acid solution is applied to the skin mucosa or damage at the test site, and the results are observed with the naked eye or with a magnifying glass after 1-5 min. In some areas such as the male penis, scrotum, female vulva and anal area, the observation time may need to be extended to 15 min after application of acetic acid. During the acetic acid test, care should be taken not to rub hard when applying the acetic acid solution to the test area to avoid abnormal results after abrasion (injury) of the skin mucosa. Judgment of results and clinical significance Acetic acid test results are divided into positive and negative. Positive acetic acid test shows that the test site or damage becomes white, and its boundary is mostly clear, there may be a very few boundaries are not very regular, some individuals are jagged, angular or feathery, and some are satellite. Small granular protrusions are seen with the naked eye or with magnification at the whitening site. The damage to the cervical area is characterized as bright, snowy white if viewed colposcopically in women and bright, snowy white and shiny in the male external genital area. A negative acetic acid test means that the test area or damage does not turn white after application of acetic acid and there are no granular protrusions. A positive acetic acid test indicates a condyloma acuminatum, a subclinical manifestation of condyloma acuminatum, or a latent HPV infection; a negative acetic acid test indicates no condyloma acuminatum, no subclinical manifestation of condyloma acuminatum, or no latent HPV infection. Clinical evaluation The acetic acid test is clinically simple, does not require complex instrumentation, and has good sensitivity. The sensitivity of the acetic acid test based on histopathological findings of condyloma acuminatum is reported to be up to 85%, but its specificity is poor, only about 12%. It has also been shown that 62% of typical and obvious HPV infections on acetic acid test are consistent with histopathological findings, while only 11% of atypical manifestations are consistent. Therefore, a positive acetic acid test result alone does not confirm acromegaly, subclinical manifestations of acromegaly, or latent HPV infection. The actual fact is that there are some lesions such as chronic inflammation of the foreskin, glans, and feminine vagina, as well as epidermal thickening or abrasion of the skin and mucous membranes, trauma, and so on, that can appear positive with the acetic acid test, called a false positive acetic acid test reaction. The main characteristics of the false-positive acetic acid test are irregular white marks in the whitening area, not very clear boundaries, and a mostly smooth surface. In addition, Candida infection of the vulva can also cause a positive acetic acid test result. It has been reported that the acetic acid test can be positive in women suspected of having cervical intraepithelial neoplasia, so further pathological examination should be performed to aid in the diagnosis when differentiating cervical intraepithelial neoplasia from cervical condyloma acuminata. A negative acetic acid test also does not rule out acromegaly, subclinical manifestations of acromegaly or latent HPV infection. The more typical clinical condyloma acuminata and HPV-positive lesions also have negative acetic acid test results. The above shows that the acetic acid test is an important clinical test in the diagnosis and differential diagnosis of condyloma acuminatum, subclinical manifestations of condyloma acuminatum and latent HPV infection, but it is not an absolutely reliable method.