Figure 24. Grainy sandy patches and trichomoniasis together.

Clusters of grains on the posterior lip of the ectocervix are both superficial and deep, millimetres to centimetres from the squamo-columnar junction (dashed line). This case is however also positive for Trichomonas vaginalis and an erythematous surface is seen with microscopic, punctate haemorrhages typical for trichomoniasis (the so-called ‘strawberry patches’). We also see fresh blood from the mucosal surface. Both diseases may cause such inflammation.