Introduction: condyloma acuminatum is caused by human papillomavirus (HPV) infection caused by genital, anal hyperplasia lesions of sexually
Introduction: condyloma acuminatum is caused by human papillomavirus (HPV) infection caused by genital, anal hyperplasia lesions of sexually transmitted diseases. Mainly occurred in the age of sexual activity active. The incubation period was about 1-8 months, with an average of 3 months. This disease is common, therefore, the incidence is very high, and is easy to relapse of sexually transmitted diseases. Although there are other ways to spread the possibility, but mainly through sexual contact transmission. In addition, the lesions in the cervix or cavity tube, etc., not timely treatment may induce cancer.
Etiology: human papillomavirus (HPV) has different subtypes. The most common cause of condyloma acuminatum HPV 6, type (type two accounted for more than 90%), etc.. HPV in the warm and humid conditions of the human body is easy to survive and reproduce, so the external genitalia and perianal is the most prone to infection.
Communication channels: there are several ways to spread.
1 sexual contact: This is the main route of transmission.
2 indirect contact transmission: it was reported that a small part of patients can spread items due to contact patients used and disease, such as underwear, bath towel, tub, toilet etc..
3 mother to child transmission: laryngeal papillomatosis and other diseases caused the baby through the birth canal can be spread in the production process, and thus encourage caesarean section.
Clinical manifestation: the incubation period ranged from 1 to 8 months (mean, 3 months).
1 Typical condyloma acuminatum
The genital and perianal area is the best, the male is more common in the foreskin, tie, coronal, glans, urethra, penis, anus, rectum and scrotum; women in the size of the labia, clitoris, vestibular, combined, cervical and anal. I can be seen in the genitals and other parts of the anus, such as axillary, umbilical fossa, oral cavity, breast and toe, etc.. Female vaginitis and male redundant prepuce is the promoting factor of condyloma acuminatum.
Early damage for petty damask papula, then gradually increase, the cluster distribution, single or wet soft, uneven surface, were papillary, cockscomb or dish pattern. Red or dirty gray. Root often pedicle, and prone to erosion exudate, touch easily bleeding. Often purulent smouldering skin cracks, caused by a stench, and can be caused by scratching secondary infection. Most patients do not have symptoms, a small number of patients may have foreign body sensation, pain, itching or sexual pain. The rectum acuteness wet wart can occur pain, tenesmus, hematochezia.
Subclinical infection of 2.HPV
Refers to the naked eye after HPV infection in clinic can not be identified, with acetic acid (with 5% acetic acid daub or wet compress after local tissue pathology or white), nucleic acid detection technology can find HPV infection called subclinical infection.
3 change the likelihood of cancer
A large number of epidemiological studies have shown that HPV infection (mainly high-risk HPV, such as HPV-16, type 18) and genital cancer are closely related, such as cervical cancer, penile cancer.
More than 1 have feculent sexual life history or spouse infection history, neonatal passive infection through the birth canal. The incubation period ranged from 1 to 8 months, with an average of 3 months.
2 typical for genital or perianal lesions such as damp place occurrence papula, papillary, cauliflower or cristate fleshy vegetations, rough surface keratosis.
3 auxiliary examination: acetic acid test positive, nucleic acid hybridization can detect HPV-DNA related sequences, PCR detection of specific HPV-DNA amplification bands, etc..
Treatment of condyloma acuminatum must be treated with combined therapy. In the removal of incentives at the same time, we should focus on improving the body immunity, physical or chemical methods to remove warts.
1 removal of incentives: to avoid contact with the source of infection, active treatment of redundant prepuce, vaginitis, foreskin glans inflammation, gonorrhea, etc..
2 improve immunity: many drugs, application of interferon, thymosin, Pi do Maude oral liquid etc..
3 chemical drugs to remove warts body: the need to guide the implementation of the doctor.
(1) 0.5% Podophyllotoxin Tincture (or 0.15% cream) for the treatment of less than 10mm in diameter of genital warts, the clinical cure rate is about 90%.
(2) 5% imiquimod cream in treating condyloma acuminatum, remove the warts for the average rate of 56%.
(3) 80% - 90% three chloroacetic acid or two chloroacetic acid
4 physical methods to remove warts:
(1) frozen therapy: the use of -196 low temperature of medical liquid nitrogen, the use of compression method for the treatment of condyloma acuminatum, tissue necrosis and promote the removal of warts, easy to operate, efficient, easy to tolerate patients. This method is suitable for small quantity, small area of condyloma.
(2) laser treatment: usually with CO2 laser, the use of cauterization treatment of condyloma acuminatum, a single or a small number of multiple body warts can be a one-time treatment of multiple or large area of the body of the wart feasible for 2 to 3 times.
(3) electric cauterization: using high frequency electro acupuncture or electric knife to remove condyloma.
(4) aminolevulinic acid photodynamic therapy (ALA-PDT therapy): selective killing of proliferating cells, not only have a damaging effect on the visible acuteness wet wart, can also remove the subclinical damage and latent infection of tissue. But the cost is high, the treatment time is longer for the larger wart body.
(5) surgical treatment: it is suitable for the giant condyloma acuminatum.
(6) immunotherapy: do not advocate alone, can be used as adjuvant therapy and prevention of recurrence. Available interferon intramuscular, subcutaneous and damage basal injection, interleukin -2 subcutaneous or intramuscular injection, intramuscular injection of polyinosinic.
All of these methods have advantages and disadvantages, combined with the economic capacity of patients, the implementation of treatment. It should be noted that during the treatment of sexually active young people as far as possible not to have a surname life, if necessary, to take protective measures. For patients who plan to have children, the need to end the treatment after 6 months before considering the child. If pregnant women infected with condyloma acuminatum, can only be considered frozen, laser or electric cauterization, such as removal of warts, can not use chemical therapy, production should consider caesarean section.
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