Genital warts
Def .: Changes caused by HPV papilla infection – the most common types 6, 11, 30, 42, 43, 44, 45, 51, 52, 54.
Epid .: Genital warts affect women and men between 18 and 28 years of age. The risk factors for HPV infections in women include: early sexual intercourse, young age, chronic inflammation, abnormal Pap smear results, many pregnancies, smoking and lack of antioxidants in the diet. Factors of high risk of HPV infection in men are: early sexual intercourse, a history of more than six partners, low level of personal hygiene and lack of circumcision.
The primary route of transmission of HPV is through sexual contact. The incubation period is about 1-6 months.
Etiol .: Human papillomavirus infection with HPV. The human papillomavirus belongs to the Papovaviridae family. More than 70 types of HPV have been identified that are responsible for causing lesions: HPV types 16, 18, 45, 56 are high risk viruses, HPV types 31, 33, 35, 51, 52, 58 are so-called viruses of moderate risk, and types 6, 11, 42, 43 and 44 are low risk viruses.
Localization: Changes in the area of the anus, the vestibule of the vagina, the pubic mound, the labia, the vagina, the cervix and the urethra, in men in the gastric groove, the mouth of the urethra and on the body of the penis and the scrotum.
DIG. 21.19. Genital warts.
Clinical: HPV infection of mucous membranes may be latent (asymptomatic) and symptomatic. The clinical manifestation are genital warts, which in the initial stage of development are small lumps with a pitted surface. Perianal condylomas may merge into cauliflower-like formations. Buschke-Löwenstein giant condylomas, i.e. tumors characterized by a slow, long-term course, with tissue destruction, but without clear symptoms of atypia on histological examination, develop very rarely from long-term, hypertrophic condylomas.
DL .: Visual examination, cytological analysis (Papanicolaou smear), colposcopy, histological examination (biopsy) and laboratory tests to detect HPV DNA.
But: There is no fully satisfactory therapy. Treatment does not eliminate genital HPV infection, nor does it prevent the disease from progressing to the neoplastic process. Topical: compounds that modulate the immune response (imiquimod, interferon alfa), which are indicated in the treatment of external genital warts and perianal warts, agents that induce chemical cytotoxic effects or physical tissue destruction – podophylline or trichloroacetic acid and dichloroacetic acid. On the other hand, the treatment of larger lesions usually involves the use of a carbon dioxide laser or surgical removal.
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