Papilloma: types, manifestations and characteristics of treatment

Papillomas are widespread in modern society. According to medical statistics, they are observed in one form or another in 80% of people and are benign small tumor -like forms on the skin and mucous membranes of different parts of the body. They are one of the manifestations of infection with the human papillomavirus (HPV) virus, a strain of which there are more than 190 species. Among them, viruses with high, moderate and low oncogenic risk are distinguished. Thus, in addition to the lack of aesthetics, papillomas can pose a serious danger to human life and health, as some of them can turn into malignant tumors.

What is HPV

The human papillomavirus infects only humans, and its main route of transmission is sexual. Therefore, HPV is most common among sexually active people. This explains the fact that the infection most often occurs at a young age at the onset of sexual activity and at its peak, that is, 15-25 years. Moreover, several types (types) of HPV can coexist in the human body, provoking the appearance of various types of formations such as tumors on the skin and mucous membranes.

The disease caused by HPV is called papillomatosis.

Infection with the virus occurs when in contact with the skin or mucous membranes with peeling skin particles or mucous membranes of an infected person. They attach to the immature epithelial cell membrane, from where it penetrates into the cytoplasm of the cell, and subsequently into the nucleus. Inside the nucleus of the cell is contained DNA, which damages HPV. As a result, when the affected cells divide, the result is the formation of new cells that are not healthy, but already have altered genetic information, which causes disruption to their reproductive and differentiation mechanisms. This causes the appearance of neoplasms on the skin and mucous membranes.

HPV infection can cause not only the formation of papillomas, but also warts, as well as flat and genital warts. However, it can be asymptomatic. In this case, the patient will not show external signs of human papillomavirus infection, but he or she will act as a carrier and can infect others during unprotected sexual intercourse or at home.

Therefore, HPV infection does not always lead to papilloma formation. It depends on the strength of a person's immunity, but more often the first small papillomas appear 1-6 months after infection.

Human papillomavirus is intracellular. Thus, with sufficient strength of the immune system, the body manages to suppress its activity and does not give the opportunity to provoke cell proliferation. But with weakened immunity due to the action of certain factors, the body's defenses fall, the virus is activated, which leads to the formation of papillomas.

All types or types of HPV can be divided into 4 groups:

• non -oncogenic - strains 1-5, 63;
• low oncogenic risk - strains 6, 11, 40, 42-44, 54, 61, 70, 72, 81;
• moderate oncogenic risk - strains 26, 31, 33, 35, 51-53, 58, 66;
• high oncogenic risk - strains 16, 18, 39, 45, 56, 59, 68, 73, 82 (types 16 and 18 are considered the most dangerous).

Oncogenic high -risk HPV strains have special genes in their DNA that are responsible for the synthesis of certain proteins, oncoproteins (E6 and E7). Therefore, when it is incorporated into the DNA of human cells, its anti-cancer protection will be reduced. Oncoproteins stabilize the skin cell genome, provoke active reproduction and suppress the ability to differentiate. Therefore, this is fraught with a high risk of developing cancer when infected with human papillomavirus strains with a high oncogenic risk.

The magnitude of the danger posed by papilloma directly depends on the type of HPV. Infection with strains with a high oncogenic risk is dangerous for its development:

• cervical cancer;
• malignant tumors of the anus, vulva, penis;
• oropharyngeal cancer, etc.

70% of cervical cancer cases are due to infection with HPV types 16 and 18.

But even infected with low-risk oncogenic strains and papilloma formation, they should be treated with caution. Convex neoplasms are often injured by clothing, bleed and tend to be inflamed. At the same time, perhaps the greatest discomfort is caused by the formation on the genitals, which causes severe discomfort and complicates the behavior of intimate life. In such cases, the possibility of secondary infection, which can lead to the development of purulent-septic complications. In addition, papillomas can form on the mucous membranes of almost all internal organs, causing disruption of their work. So, upper respiratory tract papillomatosis is often found, which causes difficulty breathing.

Causes of papilloma formation and risk factors

HPV can be transmitted sexually, also from an infected mother to her baby during childbirth. The way the virus is spread in the household is not excluded, that is, with the use of towels, clothes, etc. This explains the high prevalence of HPV in the world. Self -infection may also occur. In this case, if one papilloma is injured, the virus can be transferred to a healthy area of skin and affect it.

The main causes of HPV infection are frequent sex partner changes and unprotected sex.

But infection with the virus does not always lead to the formation of papillomas, genital warts, etc. The likelihood of developing papillomatosis depends on various factors:

• lack of immunity of any origin, including taking drugs that suppress immunity (immunosuppressants, cytostatics, etc. ), the presence of HIV infection, radiation damage;
• decreased body defenses against the background of physiological changes during pregnancy;
• the onset of early sexual activity, when the immune system is not yet fully formed and strengthened;
• microtrauma of the skin and mucous membranes;
• infection with highly oncogenic HPV strains;
• presence in the body at the same time several types of HPV;
• the presence of other sexually transmitted diseases (PMS), in particular gonorrhea, trichomoniasis, herpes, cytomegalovirus infection, Epstein-Barr virus, hepatitis B and C, etc . ;
• hormonal disorders;
• thinning, hypovitaminosis, chronic fatigue and severe stress;
• multiple births and abortions;
• the presence of severe chronic diseases, especially diabetes mellitus;
• living an unhealthy lifestyle, the presence of bad habits;
• poor living conditions.

The elderly and overweight are more prone to papilloma formation. Moreover, their neoplasms often form in the folds of the skin, which contribute to their injury and inflammation.

Types and symptoms

Neoplasms caused by HPV infection can form on the skin and mucous membranes of various parts of the body, including the face, neck and décolleté. They can also form on the arms, legs, buttocks, genitals, including the perineum, labia minora and majora, vulva, vagina, cervix, penis, especially along the coronal groove and frenulum. Damage to the mucous membranes of the oral cavity, tongue, nasopharynx, esophagus, bladder, conjunctiva of the eyes, trachea and other internal organs is not excluded.

Human papillomavirus can cause the appearance of neoplasms with different properties. In general, they can be divided into 3 groups, although in all cases the reason for their appearance is the same - infection with human papillomavirus.

• Papillomas are benign neoplasms of pink, white, pearl or light brown color, most often forming on the eyelids, lips, chest, in the armpits, in the neck. They are located solitary and usually do not tend to merge, although there are many lesions. Papillomas are usually round or wavy, resembling the head of a cauliflower, more often having legs.
• Warts are benign formations of dirty or pale brown color in the form of cockscombs or a set of villi united by the same base. Often it is found in the genital area, anus and around the mouth. They tend to merge with each other and, as a result, cover large areas of the body. Their appearance is due to infection in HPV types 6 and 11. Distinguish between pointed, flat and intraepithelial warts.
• Uneven, mild, benign tumor -like warts form in the form of plaques or small nodules on the skin surface of the hands, on the nails, feet, face, and front of the body. Warts may look like papillomas, but differ from them at the base in width. They usually occur with HPV infections types 1-5, 7-10, 12, 14, 15, 17, 19-24.

Tumor -like formations can vary in size from a few millimeters to large growths that cover large areas of skin or mucous membranes.

Also, the appearance of the neoplasm may be different, which directly depends on the type of HPV that has entered the body. More often than not, there are:

• Vulgar or ordinary - a bulge of dense consistency with a diameter of more than 1 mm. They tend to merge and congregate together.
• Plantar warts are raised above the surface of the skin, bruises are often painful with shiny surfaces and rims. Its special feature is the absence of skin patterns. Its formation is provoked by HPV types 1, 2, 4.
• Flat papillomas are soft, smooth, flat, usually round in shape having a normal or slightly yellowish skin color, pink in color. They can cause itching, so they are often injured, sore and inflamed. The cause of its formation is HPV strains 3 and 10.
• Filiform (acrochords) is one of the most common papillomas, especially in elderly patients. Often found on the face, around the eyes, in the groin, armpits, in the neck. They are yellowish in color and tend to grow gradually, turning into bruises with a dense but elastic consistency.
• Genital warts in the perineum, genitals.

Papillomas can be seen with the naked eye or are located in the thickness of the skin or mucous membranes. In the latter case, they are called endophytic and one of their manifestations is cervical dysplasia. Defeat of the female internal genitalia by papillomatosis may indicate:

• itching, burning, crying in the perineum;
• abundant whiteness;
• bloody discharge, in particular, arises after sexual intercourse;
• discomfort during intercourse.

Sometimes papillomatosis can provoke back and pelvic pain, weakness, swelling of the legs, and unnecessary weight loss. Such signs are the most worrisome, as these indicate the development of complications of HPV infection.

Diagnostics

If a papilloma forms on the body, face or genitals, you should see a dermatologist. This will make it possible not only to diagnose human papillomavirus virus infection at an early stage, but also to take measures to prevent the formation of new elements, as well as to observe existing changes.

It is very important not to hesitate to see a doctor if there are signs of growth, discoloration of the papilloma, an unpleasant odor or pain in the area of its localization.

First of all, the doctor will perform a dermatoscopy, which is an examination of the neoplasm using a special magnifying device. This will make it possible to determine its nature, as well as pay attention to the dangerous signs that indicate a high probability of deterioration of the benign formation into malignant, not to mention the formed cancer. If detected at an early stage of development, they are successfully cured and have a good prognosis in the future.

It is important that patients are advised to be tested for STDs, especially if warts are found in the genital area. Also, in such situations, women are shown to receive advice from a gynecologist, and men - from a urologist. This is important to diagnose the presence of papillomavirus lesions on the cervix, urethra, etc. and, if necessary, prescribe appropriate treatment.

To confirm papillomatous infection, patients are usually given PCR analysis. With its help, it is not only possible to confirm or rule out infection with the human papillomavirus virus, but also to determine its strain accurately.

Treatment and removal of papilloma

The treatment of human papillomavirus virus infection is always complex. Of course, you can only get rid of the annoying papilloma, but in this case there is a high risk that soon a new one or even some will form in its place. Since the main reason for the formation of papillomas is a decrease in the body's own defenses, which allows inactive HPV in the body to become active, first of all, drug therapy is prescribed to patients with papillomatosis. It includes taking immunomodulators and antiviral agents. With extensive skin and mucous membrane lesions with papilloma, cytotoxic drugs may also be prescribed. But they are taken under the supervision of a doctor, as it can cause serious side effects.

If a patient is diagnosed with an infection or equivalent disease, he or she must be given appropriate treatment for the condition, and it is sometimes necessary to see a specialist and undergo therapy under his or her supervision.

Warts of all types are subject to mandatory removal, as well as papillomas, which are often injured and inflamed. In other cases, removal is performed at the request of the patient. But it is possible to begin to eliminate the manifestations of HPV infection that can be seen only after the end of treatment of the corresponding disease, if any, and against the background of continued antiviral therapy.

In general, all modern methods of destruction or removal of papillomas can be divided into 2 major groups:

• chemical - consists in the use of various chemical compounds to get rid of papillomas, including trichloroacetic acid, dermatological preparations;
• physical - implies removal of the papilloma by surgery, using electrocoagulation, cryodestruction, laser, radio wave or plasma coagulation.

After removing the papilloma by one method or another, it is important to use a topical agent prescribed by a doctor to accelerate healing and eliminate the risk of infection.

The success of treatment and especially papilloma removal depends on the strength of the immune system. Under normal circumstances, in 90% of cases, within 2 years from the time of infection, HPV is suppressed or even completely destroyed. But this is not a guarantee that there is no risk of re -infection or the formation of new papillomas. If immunity is reduced due to the action of certain factors, papillomatosis becomes chronic, periodically gives relapses and can lead to serious complications.

To prevent infection with dangerous HPV strains and the occurrence of severe complications, it is recommended, especially for girls, to be vaccinated between the ages of 9 and 25 years.

Surgical removal of papillomas

The essence of the method is to remove the neoplasm with a scalpel, which is associated with scar formation and increased healing time. Therefore, it is used only when necessary to remove large papillomas or in cases when it is necessary to conduct histological examination, because the formation of malignant cells in them is considered.

The procedure is performed under local anesthesia, which makes it painless. The doctor removes the neoplasm itself with a scalpel and captures the healthy tissue around it. This is needed to eliminate the risk of papilloma recurrence in the same place. If having a leg, it is dissected with surgical scissors, and with the help of an electrocoagulator, the blood vessels that feed the neoplasm are "closed". The remaining wounds were sutured, treated with antiseptic and covered with sterile bandages.

Today, surgery to remove papillomas is performed mainly when there is a suspicion of cancer cell formation.

Cryodestruction

This method involves the use of low temperatures to destroy papilloma cells. This is realized through the use of liquid nitrogen, the temperature of which is -196 ° C. The essence of this procedure is to use a special nozzle or touch the papilloma with a cotton swab dipped in liquid nitrogen. Under its action, the water contained in the cell immediately turns into ice crystals, which destroy it from within. The procedure is performed under local anesthesia or without it, because the time of exposure to liquid nitrogen does not exceed 5-20 seconds.

The complexity of this method lies in the selection of the right duration of exposure to remove the papilloma to full depth and not to harm healthy tissue, which will lead to the formation of scars.

Immediately after treatment with liquid nitrogen, white spots form at the site of the papilloma. After that, small bubbles with a transparent or pink liquid content form on it, and the surrounding skin becomes red and may swell slightly. This may be accompanied by minor discomfort in the form of a burning sensation or tingling.

After 3-4 days, bubbles burst, and a crust forms in its place, which itself disappears after a few days, revealing healthy young skin. If you cannot penetrate the bladder freely, injure it or crust in other ways.

Eradication of the papilloma with liquid nitrogen is only possible if the possibility of the formation of malignant cells in it is completely excluded. This method is most often used to get rid of papillomas and genital warts on:

• centuries;
• face;
• small joints;
• genitals.

Laser papilloma removal

Using lasers to remove papillomas is also only possible if their malignancy is completely excluded. The procedure is performed under local anesthesia and consists in the evaporation of moisture on the papilloma cells with laser thermal energy. Therefore, a focused laser beam is directed at the neoplasm. The duration of exposure does not exceed 1 minute.

As a result, a crust forms at the site of the papilloma, and the skin around it becomes red and swollen. The crust will disappear on its own within a week. It can not be soaked and steamed for 3 days, also torn and injured, because of these scars. In addition, in 2 weeks after papilloma removal, it is necessary to protect the treatment area from sunlight. Otherwise, there is a high chance of hyperpigmentation of this area.

When removing a papilloma on the face with a laser, do not apply decorative cosmetics to the affected area until complete healing.

Once the crust falls off, healthy pink skin is exposed, which gradually takes on a normal color. This is the main advantage of papilloma removal with laser, as it does not involve the formation of scars and scarring. They can form only when large neoplasms are removed and the rules of care in the postoperative period are violated. Moreover, laser removal completely eliminates the risk of wound infection and is a completely non -bleeding method, because under the influence of thermal energy, immediate coagulation of small blood vessels occurs.

With the help of lasers, papillomas are mainly removed on:

• hands;
• legs and feet;
• face;
• centuries;
• neck;
• genitals.

Lasers are the only reliable way to get rid of plantar warts, as the roots can penetrate 1 cm or more into the tissue.

Electrocoagulation of papilloma

The essence of the method is to use an electric current to remove the papilloma. Using a special device called an electrocoagulator, doctors capture the papilloma and cut it into healthy tissue. In this case, there is no bleeding at all, because the thermal energy of the current is sufficient for the clotting of small blood vessels. But the procedure can be painful, especially if it is necessary to remove growths in areas of the body with delicate skin.

After electrocoagulation, a crust also forms. And the entire recovery period takes 7-10 days. Once the crust falls off, the skin underneath should be protected from damage and exposed to ultraviolet radiation.

This method is used to remove papillomas in different parts of the body. Moreover, electrocoagulation can also be used in cases where it is necessary to perform histological examination of the neoplasm and determine its nature precisely. But the outcome of the procedure depends entirely on the qualifications and experience of the doctor, however, as in other cases, because if its removal is not deep enough, the papilloma can form again in the same area.

Radio wave surgery

This method is the most advanced method in papilloma removal in any form. It involves the use of special tools. But at the same time, it has a lot in common with papilloma removal with a laser. The procedure is performed under local anesthesia, and its removal occurs directly due to exposure of the neoplasm to radio waves. Thanks to them, it is possible to cut the papilloma completely from various sizes and locations, as well as to avoid scarring.

Chemical removal of papillomas

This method involves the periodic application of special compounds on papillomas, which destroy their cells, leading to the subsequent disappearance of neoplasms. But while using such medications, it is very important not to let the substance come into contact with healthy skin.

Therefore, everyone can face the formation of papillomas. There is no effective prevention of HPV infection, and vaccines only protect against the most dangerous strains of the virus in terms of cancer risk. Even so, in most cases, they do not pose great inconvenience to a person, except for genital warts and anus, which must be removed. In any case, you can get rid of papillomas quickly and effectively, but since it is impossible to completely destroy HPV in the body with medications, and there is always a risk of being infected again or with other strains, it is possible that the problem will recur. The only reliable way to minimize the possibility of papilloma formation is by strengthening the immune system. If it appears and indicates a cosmetic defect or interferes with a person’s daily life, contact a dermatologist. The doctor will be able to distinguish the papilloma accurately from other skin neoplasms and will solve the problem in a few minutes.