These lesions have been proposed as HPV-independent p53 wild-type verruciform acanthotic vulvar intraepithelial neoplasia (HPVi (p53wt) vaVIN) or HPV independent p53 abnormal (HPV-I p53abn), encompassing lesions that fall within a spectrum of differentiated exophytic vulvar intraepithelial lesions (deVIL) and vulvar acanthosis with altered differentiation (VAAD) [2,5,11,15,16,17,18]; however, no clear etiology has been identified. The gene discussed is TP53; the disease is vulvar intraepithelial neoplasia.