I'd opt for surgery: http://www.ncbi.nlm.nih.gov/pubmed/23640441 There are various studies with various conclusions but if it were my own wife, I'd still feel most comfortable with surgery and a good pathology exam of the specimen.
Answered 8/12/2015
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Imiquimod 5%: offers a noninvasive treatment for VIN. A major advantage over the potential scarring, deformity, and/or recovery from surgery. It provides complete resolution in ~75% cases. There is a ~25% risk of disease recurrence. Imiquimod works by prompting your immune system to fight the cancer. The inflammatory response to imiquimod can result in topical side effects, requiring breaks in treatment.
Answered 8/12/2015
2.4k views
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