Degeneration of papilloma: probability with characteristic clinical picture and therapy

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Every person in his life has at least once encountered growths on the body in the form of warts or papillomas. In the last century, doctors considered papillomas only a cosmetic defect that did not carry with it any serious consequences. Now it turns out that this is not just a cosmetic problem.

Sometimes this is a serious threat to human health and life. It is very important, if you discover previously undetected growths, not to let things take their course and not to self-medicate at home, but to consult a doctor.

What is papilloma? What consequences can this skin formation have? Should you worry about the appearance of warts on your body?

Papilloma is not only a cosmetic defect, but also a risk of cancer

What is papillomavirus?

Papilloma is a lesion of the epithelial layer of the skin and mucous membranes in the form of a small papillary growth. Most often it is flesh-colored, but over time it can darken to brown. The human papillomavirus, or HPV, causes the formation of unsightly growths on the body. They usually appear as a flat wart (papilloma vulgaris) or as a mushroom-shaped lump on a stalk.

Humanity knows more than 100 types of human papillomavirus. Of these, 60 strains are harmless, causing only aesthetic discomfort. The remaining 40 provoke the formation of anagenital condylomas, papillomas on the mucous membrane of the mouth and larynx. These are already potentially dangerous.

And only a small part of human papillomaviruses can cause the development of cancer.

Benign papilloma can be found on the face, neck, armpits, sides, between the mammary glands and under the breasts.

Genital warts grow in the groin area, near the anus, on the genitals, in the vagina and on the walls of the cervix in women.

The growths are most often localized in places where there is friction of skin folds against each other or between skin and clothing. But the favorite place for papillomas is the mucous membranes, including the lips, cheeks, and larynx.

At risk are people with reduced immunity, people with diabetes, obesity, pregnant women, as well as men and women over 50. This HPV virus most actively attacks healthy cells of the body in these categories of people.

There are about a hundred strains of papillomavirus in nature.

Causes of papillomas

The human papillomavirus can be infected through a handshake, a kiss, the use of personal hygiene products, in public places, through household contact, through sexual intercourse, and less commonly at birth.

Even if HPV “dorms” in the carrier’s body for decades, skin papilloma can appear on the body due to the slightest fluctuation in hormonal levels or the flu.

Typically, the causes of papillomas include:

• promiscuous sex life;
• pregnancy;
• puberty;
• weakening of the immune system by bad habits;
• abuse of sunbathing;
• chronic diseases;
• endocrine system disorders;
• constant stress;
• depression;
• prolonged use of hormone-containing medications;
• obesity;
• AIDS and others.

Puberty is a favorable time for the appearance of growths

Type of papillomas

Thanks to the capabilities of modern diagnostic centers, several dozen HPV strains have been identified. They were divided into three main categories:

1. The virus infects epithelial cells. Papillomas can only be on the skin and are called warts (flat, vulgar, plantar).
2. Condylomas. Papillomavirus attacks the cells of the mucous membranes of the genitals, larynx, and the inner surface of the female genital organs. These types of viruses are classified as oncogenic with a low level of risk.
3. Oncogenic with a high level of risk. They provoke the development of malignant papilloma or its proliferation.

Papilloma and cancer

Can papilloma develop into cancer? Despite the fact that the vast majority of HPV strains cause the growth of benign tumors, there are types in which warts can turn into cancer. These include some types of genital warts. An ordinary brown papilloma can also mutate if it is accidentally scratched, torn off, or otherwise mechanically damaged.

More often, malignant papilloma develops into cancer on the genitals of women, on the mucous membrane of the vulva and cervix.

Cervical condylomatosis increases the likelihood of developing cancer by 40-60 times. HPV can also cause dysplasia (detachment) of the cervical epithelium.

In such cases, the formation changes its color, size and outline, the contours become inexpressive, itching or pain is felt, and redness is observed.

The potentially cancerous growth becomes hard, and the affected area can grow. Sometimes papillomas grow so densely that they eventually merge into one larger tumor.

Papillomas on the reproductive organs are more common in women, but they are also dangerous for men

Intraductal papilloma

There are also so-called intraductal growths-cysts (cystodenoma). This is a purely female disease that affects breast cells. The danger is that:

• education does not manifest itself for a long time;
• the cyst fills with blood;
• bloody fluid passes through the excretory duct and is released through the nipple;
• the cyst can easily rupture due to compression of the chest or injury;
• it can provoke necrotic processes in tissues;
• multiplying intraductal malignant papilloma can cause the development of breast cancer.

Due to the fact that this type of growth is not detected immediately, women turn to the doctor in the last stages of the disease. The problem is eliminated through sectoral resection or removal of tissue with modified ducts.

HPV treatment

There are several ways to get rid of benign growths:

• mechanical cutting with special scissors;
• laser removal;
• electrocoagulation;
• exposure to chemicals.

These methods are used to eliminate only the visible symptoms of HPV. It is not possible to kill the virus itself in the body today. The fight against the papilloma virus is carried out by enhancing the human immune system with interferon drugs.

Widespread methods for removing papillomas are also cryotherapy, that is, freezing growths with liquid nitrogen or using salicylic acid. After such a procedure, the skin may temporarily change its color and texture, but then it is restored to its previous appearance.

An oncologist deals with malignant tumors and prescribes treatment depending on the type of cancer and its degree.

Laser, like other methods, removes only the external manifestations of the disease

Prevention

There is a link between HPV and cancer, although not in all cases. But even harmless warts or small papillomas bring a lot of psychological discomfort to their carriers. Often they just get in the way, cling to clothes, and make us refuse to visit the solarium or sunbathe.

That is why it is important to take preventive measures to prevent any appearance of papillomas on the body.

1. Maintaining immunity at a high level. It is important to take vitamins regularly, eat right, give up bad habits, play sports, not suffer from diseases on your feet, and not let existing diseases develop into a chronic condition.
2. Do not overuse sunbathing or visiting a solarium.
3. Wear comfortable clothes, preferably made from natural fabrics.
4. Visit a gynecologist/urologist regularly. Use barrier contraception.
5. Be tested for HPV annually.

Recently, doctors have been insisting on vaccination to protect against oncogenic HPV types 6, 11, 16 and 18.

Despite the fact that many countries around the world have already included the vaccine in the compulsory vaccination schedule, you can study this topic thoroughly so that you are aware of all the pros and cons in advance.

Warts are warts, but don't play roulette with your health. If you find a wart, papilloma or other skin growth on your body, it is better to consult a doctor immediately. Maybe a timely visit to the clinic will save your life.

Source: https://kozhmed.ru/papillomy/pererozhdenie.html

Malignant papilloma on the skin: causes and signs of degeneration (PHOTO)

• Dermatologist of the highest category Inna Vladimirovna
• 34126
• Update date: December 2019

Papillomas are soft growths on the skin that appear due to the action of a virus.

In most cases they are harmless. However, there are dangerous strains of the virus, the activity of which can cause the formation of malignant papilloma.

Doctors also identify a number of factors that provoke the development of a pathological process in neoplasm cells.

Reasons for the development of malignant processes

In the vast majority of cases, patients are faced with ordinary papillomas or vulgar warts, which are the same thing. Such growths are not dangerous to health, although they do not look aesthetically pleasing. Their development is provoked by virus strains with minimal risk of developing cancer.

At the same time, doctors know about 100 types of human papillomavirus, about 10 of them can provoke the development of cancer. First of all, types 16 and 18 of the virus are isolated. It is these two types that provoke the development of cervical cancer in women.

The danger of HPV lies in the fact that when infected, the virus does not immediately manifest itself. When an oncogenic strain enters a woman’s body, there may be no visible manifestations of the disease for a long period.

In this case, papillomas appear on the vaginal mucosa and cervix, but there may be no growths on the skin of the body. Typically, this form of the disease is diagnosed accidentally during a routine examination by a gynecologist.

Having discovered a tumor on the cervix, the doctor sends the patient for tests, the results of which reveal HPV.

Some types of HPV are relatively harmless, while others can cause cancer.

Vulgar warts and cancer

Malignant papilloma does not only appear in the vagina. For a number of reasons, an ordinary papilloma, provoked by a harmless type of virus, can begin to degenerate into a malignant formation.

Malignant papilloma in this case appears as a result of:

• skin damage;
• exposure to ultraviolet radiation;
• papilloma infections;
• inflammatory process in the body;
• general decrease in immunity.

The process of degeneration of a benign growth into a malignant papilloma on the skin of the body is accompanied by a number of specific symptoms that are difficult not to pay attention to. Having noticed any changes, it is important to visit a doctor as soon as possible and examine the growth that is disturbing the patient.

Any damage to the growth body can trigger the process of cell degeneration. Malignant papilloma can form due to prolonged exposure to ultraviolet rays.

Signs and symptoms of malignant papilloma

Having figured out whether papilloma can be malignant, it is important to be able to recognize the beginning of the pathological process in the cells of the growth. Usually the process of degeneration is accompanied by characteristic signs of malignant papilloma. Among them:

• sudden change in color of the growth;
• increase in size;
• discomfort in the area of ​​papilloma;
• discharge of pus, blood or ichor from the head of the wart;
• throbbing pain;
• the appearance of a putrid odor.

If the growth has changed color or size, this is an alarming sign.

Knowing what malignant papillomas look like in a photo, you can compare changes in the structure of the wart and draw appropriate conclusions.

When faced with benign papillomas, many patients are confused when they see hair growing out of them. In fact, hair growth in the body of a papilloma is absolutely normal and indicates that the growth is harmless.

Symptoms of a malignant process begin to appear precisely with hair loss in the area of ​​the growth.

This is the first alarm signal that should make the patient wary and consult a doctor as soon as possible.

Benign growths can degenerate after injuries and damage to integrity. This is usually accompanied by heavy bleeding, and then a wound forms around the papilloma.

While the growth is healing, it is necessary to monitor its changes. If liquid begins to ooze from under the crust, a specific smell appears and a throbbing pain appears - this is a dangerous signal.

It is urgent to show the problematic growth to the oncologist.

The degeneration of cells into cancerous ones is facilitated by contact with household chemicals, as a result of which a change occurs in the structure of the growths. In this case, papilloma can increase many times in size compared to benign growths.

Any changes in the appearance of papillomas and moles are a reason to visit a doctor

When to see a doctor?

If you notice the appearance of a nonspecific papilloma on the skin, which differs in color or size from benign growths, you should contact an oncologist.

Damage to the wart at home is also a cause for concern. It can be accidentally scratched with nails, rubbed with clothing, or cut off with a razor. Normally, such damage does not cause complications, but the cells of some papillomas can develop into cancer.

Dermatologists warn: any papilloma that interferes with everyday life or causes discomfort must be removed. Otherwise, repeated damage to the integrity of the growth may trigger the onset of pathological cell degeneration.

Diagnosis of cancer

If you suspect a malignant papilloma, you should undergo a series of examinations. First of all, the doctor will examine the growth using a special device that magnifies the image many times. Pathology can be suspected by visual examination, based on structural changes in papilloma skin cells.

Then you need to take a PCR test, which determines the types of papillomaviruses. The next step is removal of the wart for the purpose of histological examination of the cells. Treatment for the disorder begins only after confirmation of the diagnosis.

Treatment principle

Treatment of malignant papilloma consists of its removal. To do this, use any of the professional methods - cryodestruction, laser burning, electrocoagulation.

If malignant cells are found in the growth, the skin around the growth is further examined.

When the pathological process spreads to healthy tissue, traditional oncology treatment methods are prescribed - radiation and chemotherapy.

For papillomas on the mucous membrane of the genital organs, treatment also begins with removal of the growth and examination of its tissue. A biopsy is not performed if a malignant papilloma is suspected. This procedure is accompanied by cell damage, which can negatively affect the rate of development of the pathological process. If cancer is confirmed, comprehensive treatment is carried out by an oncologist.

Additionally, the patient may be prescribed antiviral drugs that suppress the activity of the virus. This is necessary to avoid relapse after chemotherapy.

It is strictly not recommended to try to remove papilloma that has changed color or shape on your own at home.

In case of cancer, available means for removing warts (alkalis, acids, celandine juice) greatly increase the health risk.

Prevention methods

The most effective way to prevent dangerous changes in papilloma cells is to prevent infection with the virus. For this purpose, vaccination is carried out to protect against dangerous strains. This vaccination is prescribed to girls under 12 years of age to prevent the development of cervical cancer at an older age.

Source: https://DermatologInfo.ru/papillomy/priznaki-zlokachestvennoj-papillomy/

Can papilloma develop into the fatal disease cancer?

New growths on the skin, papillomas and warts, have long been considered safe if they are not injured; they rarely become malignant and degenerate into a malignant tumor. However, studies show that the risk of developing cancer in people with papillomas is quite high. Can papilloma develop into cancer and how to avoid it?

What is papillomatosis

The formation of growths on the skin is caused by infection with the human papillomavirus, which is present in almost 90% of people around the world.

HPV is very contagious, infection occurs through household contact or sexual contact. You can become infected even by shaking hands or on public transport. But our immune system tries to protect the body from the virus.

Most often, once it gets on the skin, it is destroyed and does not cause virus carriage.

If a person has reduced immunity, then HPV not only penetrates the cells of the epidermis, but can also cause a disease such as papillomatosis, the formation of papillomas, warts, and genital warts on the skin and mucous membranes.

Papillomatous neoplasms on the skin are benign tumors that, as a rule, do not turn into cancer even throughout life. However, degeneration into a malignant tumor is still possible.

It depends on the type of HPV a person is infected with and predisposing factors.

When there is a risk of papilloma degenerating into cancer

More than 600 HPV strains have been identified and described, more than 60 of which have increased oncogenicity. That is, when infected with one of these viruses, papillomas can malignize into a cancerous tumor. This is facilitated by various factors, primarily the oncogenicity of the virus.

Thus, highly oncogenic viruses include types 16 and 18; they are most often found in female genital cancer. HPV and cancer are interrelated, but there are not many highly oncogenic viruses.

There are strains of medium, low oncogenicity, which in the absence of predisposing factors will never lead to oncology.

Women are more likely to become infected with HPV than men, since one of the predisposing factors for the virus to enter the body is an increased level of estrogen. They are more likely to develop cancerous changes in the genitals.

Back in the 12th century, it was noticed that tumors of the genital organs were more often detected in women who had growths and papillomas on the body, but they practically did not occur in virgins.

Tumor formation can begin when:

• decreased general immunity;
• hereditary predisposition;
• injury to papillomas;
• chronic diseases;
• stress;
• exposure to carcinogenic substances;
• exposure, radiation, including excessive exposure to sunlight.

Hereditary predisposition is the presence in the human body of a certain type of mutation that is inherited. Most often, they act on the immune system, or rather, they are the cause of its defect, when our body does not notice the changed cells and allows them to multiply uncontrollably.

A decrease in immunity also occurs under the influence of external factors (radiation, environmental pollution, etc.).

In addition, the lack of normal, nutritious nutrition, chronic diseases, the presence of foci of infection, bad habits (smoking, alcohol) can significantly weaken the human body.

For example, infection with sexually transmitted infections can trigger the development of a tumor.

Trauma to growths can also cause malignancy of papillomas. Therefore, it is better to remove formations immediately, especially if they are located in places subject to friction.

There are many different methods for treatment - medicinal, surgical, as well as traditional medicine.

Don't hesitate or be afraid! Modern methods make it possible to prevent degeneration into cancer; you just need to consult a doctor in time.

Signs of degeneration

Many people ask: “If a papilloma or wart appears, when should you go to the doctor?” There can only be one answer: “The sooner the better.”

Of course, most of the formations do not degenerate, but it is worth getting examined and making sure that your papillomas are not dangerous, and it is better to immediately remove this source of HPV spread and take care of yourself, help the body get rid of the virus on its own.

Particularly dangerous are condylomas and papillomas on the mucous membranes of the genital organs, in the oral cavity, pharynx, and mammary ducts. They need to be removed and treated in time!

The signs of papilloma degeneration into a cancerous tumor are as follows:

• color change;
• smoothing contours;
• violation of the skin pattern;
• the appearance of cracks, ulcerations;
• rapid increase in size;
• inflammation of the skin around the formation;
• discomfort, itching, burning.

If any of these signs appear, you should consult a doctor. If the tumor is located in a hard-to-reach place and it is difficult to observe its development, you need to pay attention to the accompanying signs.

For example, with papillomatosis of the oral cavity and larynx, pain may occur in a certain area or when swallowing.

And condylomas in the vagina can cause increased formation of discharge, itching, and burning.

Diagnosis and treatment

Diagnosis of papillomas and identification of their oncogenicity is carried out using special clinical tests, which should determine how dangerous the strain that caused the formation of the tumor is and whether there are changes in the cellular structure. The following analyzes are used for this:

• polymerase chain reaction to determine HPV type;
• Digene test is more effective than PCR and shows the amount of virus in the body;
• Pap test - allows you to detect changed cells.

If degenerated cells are detected, removal of the formation is not enough; extensive intervention, as well as radiation and chemotherapy, may be required.

Cancer Prevention

The connection between papilloma and cancer is quite obvious. The development of the oncological process can be prevented by timely treatment of papillomas and prevention of HPV infection. Doctors recommend:

• avoid promiscuity;
• increase general immunity;
• remove formations when they occur;
• carry out treatment of neoplasms in medical institutions where it is possible to determine the risk of cancer (HPV strain, cytological examination).

Currently, a vaccine has been developed against some of the most oncogenic strains of HPV. Vaccination is carried out using several vaccines, for example "Gardsil" (types 16, 18, 11) or "Cervarix" types (16, 18).

They work if a person is not yet infected. Therefore, they are used from the age of 9 until sexual activity.

If infection has already occurred, for example, with strain 18, then vaccination is useless, although it can protect against infection with types 16 and 11, and therefore reduce the risk of developing cancer.

Therefore, you can avoid the degeneration of skin tumors into cancer by adhering to a healthy lifestyle, eliminating the effect of carcinogens on the body, hardening yourself, and playing sports.

If you want to prevent the development of cancer, then try to follow these simple recommendations, consult a doctor on time and do not get carried away by fashionable trends (diet, fasting, solarium), which are not always beneficial for the body.

At your request they are also reading:

Source: https://opapillome.ru/simptomyi-i-diagnostika/mozhet-li-papilloma-pererasti-rak.html

"Hapillomavirus infection - clinical picture, diagnosis, treatment"

THE LECTURE COVERS ISSUES OF ETIOLOGY, PATHOGENESIS, CLINICAL MANIFESTATIONS OF HAPILLOMAVIRUS INFECTION. AS WELL AS MODERN APPROACHES TO DIAGNOSIS, TREATMENT AND PREVENTION OF THIS DISEASE. THE IMPORTANCE OF SPECIFIC PREVENTION OF HAPILLOMAVIRUS INFECTION WITH A QUADRIVALENT RECOMBINANT VACCINE IS EMPHASIZED.

In recent years, diseases associated with the human papillomavirus (HPV) have increasingly attracted the attention of doctors of various specialties, including obstetricians-gynecologists and pediatricians.

Today, HPV infection is one of the most common sexually transmitted infections (STIs), which affects most of the sexually active population of the planet. The peak of HPV infection occurs at a young age from 15 to 30 years, amounting, according to various authors, from 17.6 to 20.8% among women in this age group.

After 30 years, the frequency of HPV infection ranges from 8.6 to 9.9%, while the detection of dysplasia and cervical cancer increases significantly. About 35 types of HPV cause damage to the covering epithelium of the mucous membranes of the genital organs, and approximately 99.7% of all squamous cell carcinomas of the cervix contain HPV DNA.

HPV is one of the main etiological agents of both genital and non-genital carcinogenesis. Every year, more than 600,000 cases of cancer associated with the human papillomavirus are detected worldwide, which is 12% of all cancers registered in women.

Genital warts (condylomas) have a rich history. They were widely known in the ancient world, where doctors gave them this name (condylomas - meaning “figs”). The viral nature of condylomas was confirmed in the 50s of the 20th century, and in 1976, two new morphological types of HPV lesions were discovered, called flat and inverted (endophytic) condylomas.

Subsequently, such lesions began to be associated with concomitant intraepithelial neoplasia and sometimes with invasive squamous cell carcinoma of the cervix. Currently, cervical cancer occupies a leading position in terms of female mortality among cancer diseases.

ETIOLOGY

The capsid is an icosahedron (twenty-hedron) measuring approximately 55 nm in diameter, consisting of 72 capsomeres. HPV does not contain lipids and is inactivated by fat solvents. During the replication process, the virus secretes from 8 to 10 proteins, the synthesis of which is controlled by “early” and “late” genes.

“Early” genes (E6 and E7) control the processes of replication, transcription and transformation. They are responsible for the oncogenic properties of HPV, partly due to the fact that they bind proteins in epithelial cells - cell division regulators p53 and Rbl05, thus inactivating their suppressive functions. The “late” genes L1 and L2 encode structural proteins of the virion.

The E6 and E7 genes are always found in tumor cells. Other fragments of the viral genome are not detected, as they may be lost during its long-term replication.

The replication process of human papillomavirus is divided into two main stages:

• The initial stage of the HPV infectious process is characterized by the persistence of the virus in episomal form. During this period, the cell is capable of producing viral particles. This stage is called the stage of reproductive infection.
• Late stage - integrative infection. At this stage, the viral DNA is inserted or integrated into the genome of the infected cells. It is this stage that corresponds to the true latency of HPV in the host body. The initial stage is reversible, and many infected people go into remission. The stage of integrative infection is the first step towards tumor degeneration of cells and very often ends in the development of carcinoma.

These stages of viral infection correspond to two different clinical forms of the disease: transient and latent, respectively. Integration of viral DNA into cellular DNA may, as already noted, be accompanied by the loss of viral material, however, the transcription of the E6 and E7 genes is preserved, and they can be detected at this stage by immunofluorescence analysis. In contrast, the viral genome in its integrated form is not capable of complete replication and, therefore, is not detected during laboratory diagnostics. The transient form (carriage of the virus) is often found in clinical practice - these are cases of anogenital papillomatosis in adolescents and people who are not sexually active, in pregnant women against the background of physiological immunosuppression, etc. In the latent form of infection, HPV-infected epithelial cells multiply in the host’s body. In addition, during the integration of viral DNA into cellular DNA, mutations of cellular DNA occur, causing genome instability. Active proliferation of a clone of cells with mutant DNA containing integrated viral DNA leads to tumor growth.

Currently, there are about 180 types of HPV, of which 29 types have oncogenic potential. Based on the degree of oncogenic risk, the following HPV groups are distinguished:

• “Low” risk HPV - types 6, 11, 40, 42, 43, 44, 54, 61, 70, 72 and 81;
• “Moderate” risk HPV - types 26, 31, 33, 35, 51, 52, 53, 58 and 66;
• “High” risk HPV types 16, 18, 39, 45, 56, 59, 68, 73 and 82.

PATHOGENESIS

HPV infects proliferating epithelial cells in the basal layer of the epithelium. Infection of the epidermis occurs through microdamages (mechanical, bacterial, etc.), the depth of which reaches the basal layer.

Single viral particles are sufficient for the development of an infectious process. Virus replication occurs only in the cells of the basal layer, and in the cells of other layers of the epidermis, viral particles only persist.

Thus, the cells of the basal layer are a constant source of infection of epithelial cells, which then undergo successive stages of differentiation with a persistent and replicatively inactive virus. After infection with HPV, the normal process of differentiation in epidermal cells is disrupted, especially for cells of the spinous layer.

In them, clonal expansion, transformation and subsequent malignancy of HPV-infected cells of the basal layer, which have undergone only primary differentiation, occur.

Cells of the spinous layer of the epidermis, upon transition to the granular layer, most actively synthesize viral DNA, but only in the stratum corneum does the active assembly of mature viral particles occur, their release from the cells and budding directly on the surface of the epithelium or epidermis. Contact with these areas leads to infection.

The host immune response is aimed at preventing clinical manifest HPV infection. Cellular immunity has a blocking effect on the persistence of the virus and, in some cases, promotes spontaneous regression of lesions. Spontaneous regression of papillomatous growths can occur after 6-8 months.

The participation of cellular immunity in this process is confirmed by the detection of a large number of CD4 and CD8 lymphocytes in the infiltrate of regressing condylomas. It should be noted that HPV is a weak antigen and a weak inducer of endogenous interferon, although it is quite sensitive to exogenous interferons. Immunity for HPV infection is type-specific, non-crossover (does not protect against infection by other types), relaxed, low. Consequently, infection of neighboring areas of the epithelium is possible. Often with HPV infection there is a decrease in cellular immunity, as well as a deficiency of local and general interferon.

EPIDEMIOLOGY

The target organs for HPV are, first of all, the skin and mucous membranes of the anogenital area and upper respiratory tract, and less often - the oral cavity, esophagus, rectum, bronchi and conjunctiva of the eyes.

People who cut fish, meat and poultry often have clinical manifestations of HPV infection. The “gates” for the virus are minor defects in the skin and mucous membranes. Infection can also occur through autoinoculation (self-infection) during shaving, epilation, biting nails, or scratching the skin.

In cases of severe immunodeficiency, “contamination” can become systemic. Manifestations of human papillomavirus infection in the anogenital area are often preceded by nongenital forms of papillomas for several months.

Genital warts are transmitted sexually. In 65-70% of cases they are detected simultaneously in both sexual partners. Significant differences are observed in those married couples where the woman develops cervical cancer associated with HPV infection.

In these patients, HPV DNA is detected by PCR in 83% of cases, and in their partner - in 67%; and HPV type 16 DNA - in 70 and 30% of cases, respectively. It has been proven that an oncogenic fragment of the HPV genome can be present on sperm. Newborns can be infected during labor by passing through the birth canal of a mother infected with HPV.

Such children may subsequently develop recurrent respiratory papillomatosis. Laryngeal papillomas can cause airway obstruction, which requires surgical treatment. There are reports of the presence of HPV in amniotic fluid.

Cases of children being born with laryngeal papillomatosis during delivery by cesarean section have been described, which also confirms possible intrauterine infection of the fetus.

There is also a transfer of HPV infection from parents to children, and cases of mass diseases among schoolchildren. Genital manifestations of infection can be combined with extragenital ones. Children are more likely to suffer from vulgar and juvenile warts.

Risk factors for developing HPV infection are:

• early onset of sexual activity, a large number of sexual partners;
• contact with a woman with cervical cancer or genital papillomatosis;
• association of HPV with other STIs (chlamydia, urogenital mycoplasmosis, gonorrhea, trichomoniasis, bacterial vaginosis, HSV infection, HIV, cytomegalovirus infection, syphilis, etc.);
• local irritants (discharge from the vagina, urethra, rectum in various pathological conditions, maceration, accumulation of smegma, etc.);
• dysbiotic conditions;
• smoking, alcohol;
• transient immunodeficiency states that occur due to vitamin deficiency, excessive insolation, atopic dermatitis, pregnancy, treatment with cytostatics, etc.

CLINICAL PICTURE

The incubation period for HPV infection varies from 3 weeks to 9-12 months (average 3 months). Transformation of an infection caused by a high-oncogenic risk HPV group into cervical, anal or skin dysplasia or cancer usually occurs within 5-30 years (rarely up to 1 year). The following clinical forms of HPV infection are distinguished:

• Manifest - in persons with a transient disorder of the cellular component of immunity (for example, pregnancy); with the presence of genetic limitation of specific HPV immunity (HLA-DQW3 system); in HIV-infected people.
• Subclinical - in immunocompetent individuals.
• Latent - described in detail earlier in the case of integration of viral DNA into the cellular genome. Factors contributing to the transition of latent infection to manifest infection are concomitant STIs, smoking, hormonal contraception, transient immunodeficiency states and others.

About 90% of cases of genital condylomatosis are caused by HPV types 6 and 11. Condylomas acuminata with exophytic growth (classic form) initially appear as small papillary limited nodules the color of normal skin or mucous membrane.

Gradually they turn into thread-like growths of considerable size, reminiscent in appearance of a cockscomb or cauliflower. Exudate accumulates between the papillary growths, the surface becomes moist, shine, soreness, an unpleasant odor appear, and maceration may occur. The papillae consist of loose connective tissue.

As a rule, swelling and pronounced inflammatory infiltration are observed. In each actively growing papilloma, centrally located blood vessels are visible, which distinguishes it from a regressing, smoothed one, covered with thickened epithelium. The papillae are covered with thickened stratified squamous epithelium, with signs of parakeratosis.

acanthosis and hyperpalasia of the cells of the basal layer. Genital warts are localized mainly in places of friction and trauma during sexual contact. In women, the frenulum of the labia, labia majora and minora, clitoris, urethra, pubis, perineum, perianal area, vestibule and entrance to the vagina, hymen, vagina, and cervix are affected.

In the urethra, condylomas are located in a ring shape, mainly in the area of ​​the external opening of the urethra. This localization of the lesion in women occurs in 4-8% of cases.

Deeper damage to the urethra is accompanied by symptoms of persistent urethritis. Patients complain of unpleasant feelings of discomfort or burning when urinating, pain in the lower abdomen and in the external genital area.

Particularly rapid growth of genital warts is observed in pregnant women, which is due to the presence of physiological immunodeficiency. During pregnancy, condylomas can be vascularized and, rapidly enlarging, close the genital tract. After childbirth, this process may resolve spontaneously.

Such condylomas often ulcerate, a secondary infection occurs, and perifocal inflammation occurs, accompanied by pain, itching, pathological discharge and an unpleasant odor. Perinatal infection with HPV infection can lead to laryngeal and genital papillomatosis in children.

Source: https://www.HerpesClinic.ru/publikacii/stati-v-zhurnalah/45/

Human papillomavirus | University Clinic

Human papillomavirus (HPV) is one of the infections that can be sexually transmitted. The disease is often asymptomatic. The virus can “give itself away” only by the appearance of papillomas and condylomas on the skin and mucous membranes of the inguinal and perianal areas. Formations can be either single or multiple.

The danger of the human papillomavirus lies in provoking the cancerous degeneration of epithelial cells. Women can develop cancer of the cervix, men can develop cancer of the genital organ, and patients of both sexes can develop cancer of the anal area, rectum and oral cavity.

Many types of HPV have been identified, but only a few are oncogenic. Therefore, it is not enough to detect the presence of the virus in the patient’s body. It is also necessary to determine its type in order to further determine treatment tactics.

Methods of transmission of HPV

There are three main ways of transmitting the virus:

• sexual;
• contact;
• vertical (from mother to child).

Sexual transmission of the virus is the most common. The likelihood of infection is approximately the same during anal, oral or vaginal intercourse.

Violation of the integrity of the skin and mucous membranes, inflammation of the mucous membranes increases the risk of infection.

For example, if a woman has cervical erosion, the virus will penetrate the tissue and begin to multiply more likely than in a woman without violating the integrity of the mucous membrane of the genital organs.

There is a higher risk of infection from partners who have characteristic rashes, especially genital warts, which are easily injured when touched. Using a condom can reduce the chance of infection, but not completely.

In the external environment, the virus is unstable, but the time until the viral particles can remain viable on surrounding objects is quite enough to become infected. Transmission of the virus by contact can be observed in everyday life and in crowded places.

The risk of infection of the child during childbirth is a good reason to postpone conception and undergo treatment.

Features of the course of the disease

HPV refers to hidden sexually transmitted infections that may not appear for years.

Sometimes characteristic elements (papillomas and condylomas) appear on the mucous membranes and skin, but in some cases there are no symptoms that allow a person to suspect the disease.

This facilitates the spread of the virus among people, and in case of infection with an oncogenic type of virus creates a high risk of late detection of cancerous tissue degeneration.

Eliminating the virus does not eliminate the risk of developing cancer. After a few years, the process of cancerous degeneration of cells may begin.

Types of cancer that can develop after HPV infection

Until recently, cervical cancer was the main type of cancer caused by the HPV virus. In recent years, oncological diseases of the oropharynx, rectum and anal area have become more common. Every year the number of cancers caused by oncogenic types of HPV is growing.

Factors that increase your chance of developing cancer

The main condition for the development of the disease is the entry of the virus into the body. The risk of infection is higher in the following categories of patients:

• frequently changing sexual partners;
• preferring anal and oral sexual intercourse;
• having sexual relations without using a condom.

You can become infected with HPV an unlimited number of times. Accordingly, the likelihood of an oncogenic type of virus entering the body increases significantly.

Cancerous degeneration of epithelial cells occurs under the influence of HPV proteins, which are released during the multiplication of viral particles. These compounds change the normal course of metabolic processes in epithelial cells and the nature of their division.

The likelihood of developing cancer is influenced by the duration of the infection in the body, infection with a certain type of HPV and the state of the immune system. Malignancy is provoked by:

• acute and chronic diseases;
• chronic intoxication of the body in smokers and alcohol drinkers;
• lack of physical activity;
• acute and chronic stress, overwork, insufficient night sleep.

Ways to prevent HPV infection

You can reduce the likelihood of infection by:

• using a condom;
• treating the skin and mucous membranes immediately after sexual intercourse with antiseptic solutions, and for men also washing the urethra with antiseptics if sexual intercourse was performed without using a condom;
• use of personal hygiene products.

HPV vaccination

There are vaccines that induce the development of immunity to oncogenic types of HPV. The drugs are widely used in the West and have already proven to be highly effective in reducing the likelihood of developing cervical cancer. Vaccination in Russia is provided to everyone on a paid basis, but in a number of cities special targeted programs are offered when teenage girls are vaccinated for free.

Diagnosis of HPV and dysplasia

To make a diagnosis, the following is carried out:

• general or urological examination;
• taking smears from the genital organs for cytological examination;
• collection of biological material for a PCR study, which makes it possible to establish not only the presence of the virus in the body, but also its type.

Changes in epithelial cells (dysplasia) are detected during a cytological examination. The degree of changes in cells and the depth of spread of atypia in the thickness of the skin or mucous membrane are also important for determining tactics. The deeper the altered cells are located, the worse the prognosis.

HPV treatment

A number of studies indicate that antiviral drugs for HPV do not have a noticeable effect. Immunostimulants and immunomodulators may be prescribed in cases where a decrease in the activity of the immune system can be suspected.

To prevent the spread of the virus, it is mandatory to remove papillomas and condylomas from the surface of the skin and mucous membranes. Laser or radio wave removal is used for this.

In the presence of ectopia or erosion, destruction or cauterization is performed. Otherwise, the virus will further change tissue in the direction of atypia, dysplasia or cancer. This avoids the development of malignant tumors.

Source: https://unclinic.ru/virus-papillomy-cheloveka/