What is condyloma acuminatum? Condyloma acuminatum, also known as condyloma acuminata, are genital warts. It is a skin disease caused by the human papillomavirus (HPV).In the past 15 years, the number of cases of condyloma acuminata in the United States has increased fivefold. In my country, condyloma acuminatum is also one of the most important sexually transmitted diseases, ranking second or third in sexually transmitted diseases in many regions. By 2001, the actual number of patients in our country had exceeded 10 million, and the number of patients was still on the rise.
What is HPV?
HPV is the abbreviation of Human papillomavirus, the English name of human papillomavirus.HPV is a DNA virus that is obviously host and tissue specific. The only host of HPV on the layered squamous epithelium of human skin and mucous membranes has not been successfully cultured in vitro. The diameter of the virus particles is 50~55nm. This is very small and cannot be seen with an optical microscope. It can only be seen with the help of an electron microscope. The current genotyping subtypes have reached more than 200 species, of which more than 30 subtypes are related to the occurrence of condyloma acuminatum.，
What are the high-risk and low-risk types of HPV?
Clinically, HPV can be divided into low-risk and high-risk types based on the different pathogenicity or carcinogenic risk of HPV subtypes. The low-risk type mainly causes condyloma acuminatum in the anus, external genitals, urethra, lower vagina, and other parts, as well as low-grade cervical intraepithelial neoplasia CINⅠ.Such as HPV611, 30, 39, 42, 43, 44 subtypes.In addition to causing genital warts, high-risk types can also cause external genital cancer, cervical cancer, and highly cervical intraepithelial neoplasia CIN, CINⅢ, such as HPV16、18、31、33、35、45、51、52、56、58、 61, etc., especially HPV16 and HPV18.
What are the manifestations of condyloma acuminatum in men?
Male condyloma acuminata occurs in the foreskin lacing, coronary sulcus, foreskin, urethra, and pubic spasm, around the anus and scrotum. At the beginning of the disease, it is a pale red or dirty red millet-like neoplasm, soft in nature, slightly pointed at the top, and gradually grows or increases.
What are the manifestations of condyloma acuminata in women?
Female condyloma acuminata is mainly found in the vagina, especially in the clitoris, labia, and vagina, around the anus, and cervix. The damage is manifested as papillary, cockscomb-shaped, or fused into cauliflower-shaped, varying in size, partially fused into pieces, or with plaque-like manifestations. Women can generally find damage to the vulva or perianal through self-examination, but HPV that occurs in the vagina and cervix is more hidden and not easy to detect. It is easy for patients to ignore the occurrence of the disease.
What are the special parts of condyloma acuminatum?
There are not a few patients with condyloma acuminata in the perianal, anal canal, and rectum in dermatology outpatient clinics. Among them, many gay anal sex behaviors are infected, and some are contracted after anal sex by heterosexuals seeking a variety of sexual methods, and some are infected by hand inoculation or contaminated toiletries. The perianal condyloma acuminata is often enlarged, shaped like cauliflower, the surface is moist or bleeding, and it can emit a foul smell, which will accelerate the spread after scratching. Condyloma acuminata in the anal canal or rectum can cause pain and blood in the stool, while large condyloma in the rectum can cause acute and severe pain. It has been reported abroad that condyloma acuminata in the rectum, which has not been cured for a long time, has the possibility of developing into bowel cancer.
What diseases are condyloma acuminata most easily confused within men?
The pearl-like papular disease of the penis
What diseases are condyloma acuminata most easily confused with in women?
False condyloma
Who does condyloma acuminata occur to?
This disease occurs in sexually active people who have an unclean sex life, mostly in the age group of 20 to 40 years old.
Are condyloma acuminata contracted through unclean sex?
70% of the people with condyloma acuminata are infected by sexual contact, while 30% of patients are infected by non-sexual contact transmission routes, such as
- Infection by contact with objects
- Iatrogenic infection
- Smoke infection
- Mother-to-child transmission
- Autologous vaccination, infection, etc.
How long is the incubation period of condyloma acuminata?
It takes a period of time from HPV infection to human skin and mucous membranes to the appearance of condyloma acuminata damage. This period of time is called the incubation period of condyloma acuminate. The length of the incubation period of condyloma acuminata varies from person to person, generally ranging from 2 weeks to 10 months, with an average of 3 months. Some of the longest ones are about 12 months old.
Can I treat condyloma acuminata by myself without treatment?
Some foreign scholars speculate that 1/3 of the initial external genital warts can subside on their own within 6 months, while 2/3 of warts will not subside and develop further. However, in actual clinical observations, spontaneous regression is rare, and because it grows in the genital area, the patient has an urgent desire for treatment.
Does condyloma acuminatum occur after a person is infected with HPV?
Not necessarily, because there are many diseases caused by HPV in addition to condyloma acuminata, such as flat warts, plantar warts, warts Vulgaris, Bowen-like papular disease, cervical cancer, cervical intraepithelial tumors, vulvar intraepithelial tumors, penile intraepithelial tumors, perianal intraepithelial tumors, skin squamous cell carcinoma, warty epidermal dysplasia, etc.
What are the results of HPV entering the human body?
- Long-term lurking
- Subclinical infection、
- Causes a variety of skin diseases, including condyloma acuminata
- Develop into a tumor
- Subside on its own
What is the latent infection of condyloma acuminata?
HPV latent infection refers to the presence of HPV virus DNA but no virus particles are formed, and the cell morphology is normal. The latent infection of HPV cannot be diagnosed by cytology or histology, but it can be confirmed by DNA examination.
What is the subclinical infection of condyloma acuminata?
Subclinical HPV infection means that the patient has no symptoms and signs, but has cytological abnormalities consistent with HPV infection. Clinically, it can be confirmed by cervical smears, colposcopy, tissue biopsy, white acetate test, or DNA test. The subclinical manifestations of condyloma acuminata play a very important intermediate "bridge" role in the process of HPV latent infection to condyloma acuminata, and the outcome of its evolution is related to factors such as the body's immune function.
Can condyloma acuminata be diagnosed through the white acetate test?
No, for atypical condyloma acuminata, doctors often use white acetate tests to assist in diagnosis, which has high accuracy, but this cannot be regarded as the gold standard for diagnosis. A typical condyloma acuminata, can be diagnosed in a variety of ways.
Why does condyloma acuminata always recur?
There are many factors that cause the recurrence of condyloma acuminata, such as the existence of subclinical HPV infection and latent infection, incomplete treatment of warts, HPV reinfection between spouses, poor autoimmune immunity, the male foreskin being too long or phimosis, female vaginal discharge or wet vulva, self-vaccination transmission, exposure to HPV-contaminated items, long-term psychological and mental depression and tension, inability to follow the doctor's instructions for regular follow-up, excessive smoking and drinking, and other factors.
Why is condyloma acuminata transmitted through skin lesions?
Humans are the only host of HPV. Moreover, HPV has the characteristics of strictly epithelial cells. After HPV invades the body, the virus is mainly limited to the skin and mucosal epithelial cells.HPV does not enter the blood and spreads to the whole body, and does not produce toxemia. Before HPV enters the epithelial cells of the skin mucosa, the skin mucosa must first be damaged. This kind of damage may be slight, often invisible to the naked eye, or it may be more obvious damage. Minor injuries caused by sexual intercourse, scratching, friction, etc. can give HPV a chance to enter the body.
Will HPV in patients with condyloma acuminata be transmitted through the blood?
No. The pathogenesis of condyloma acuminata is mentioned in the "Urology" edited by Academician Wu Jieping: "In sexual contact with an infected person, HPV enters the skin mucosa of the contact person through minor damage to the skin or mucous membrane. HPV stimulates the basal cells of the epidermis and divides, causing proliferative damage to the epidermis.HPV-DNA and virus particles can only be detected in the granular layer of the epidermis and the cells in its upper part.”After the virus enters the infected site, it only survives in the epidermis and mucous membranes of the skin. Except for the cells in the epidermis and above, the virus particles cannot be detected in other parts.
Is the blood drawing test accurate in diagnosing condyloma acuminatum?
Inaccurate HPV mainly infects humans through direct or indirect contact with contaminated products or sexually transmitted infections. After the virus invades the human body, it stays in the skin and mucous membranes of the infected area and does not produce viremia. Within 1 to 2 months of the appearance of the infected lesion, corresponding antibodies to the virus are produced in the blood. At this time, if the blood is drawn for examination, the result will be positive, and the positive rate is about 50-90%. But this positive result is only positive for antibodies, not positive for viruses.HPV is divided into more than 200 types and can cause more than ten kinds of diseases, such as some cause flat warts, some cause common warts, some cause condyloma acuminata, and some cause other diseases. An ordinary person with a scorpion on his body goes to draw blood to test for HPV, and the result is also very likely to be positive. But at this time, we cannot rely on this positive result, which means that this person is suffering from condyloma acuminate. Therefore, blood tests cannot verify whether you have condyloma acuminata.
What are the treatment methods for condyloma acuminatum?
Photodynamic therapy, microwave therapy, cryotherapy, laser therapy, electrocautery therapy, surgical resection, surgical scraping method, surgical ligation method, drug therapy (5-Fu, ghost mortar toxin ointment, Imiquimod cream, trichloroacetic acid, Pingyang Moxa, etc.) and so on. The specific therapy to be used for treatment needs to be decided by both doctors and patients according to the patient's condition.
What are the advantages of photodynamic therapy in the treatment of condyloma acuminatum?
- Therapeutic drugs are highly selective for skin mucosal cells infected by the HPV virus.;
- Non-toxic, harmless, and non-destructive;
- The only therapy that has a therapeutic effect on HPV subclinical infection and warts at the same time;
- Photodynamic therapy has a low recurrence rate of only 5~10%. The recurrence rate of others is 30~40%.
- Treatment has a diagnostic value at the same time.
- It can also be treated for special parts of the urethra, urethra, cervix, rectum, or anal canal that cannot be effectively treated by other therapies, such as condyloma acuminata.
Can infusion with antiviral drugs treat condyloma acuminata well?
Antiviral broad-spectrum drugs have a positive effect on the herpes virus, but there is no evidence-based medical evidence to support the HPV virus that causes condyloma acuminata, and there is little difference in the efficacy of clinical use or not. But the cost of infusion with such drugs will be very high.
Can condyloma acuminatum be prevented by the HPV vaccine?
The HPV vaccine is mainly used to prevent cervical cancer. It is suitable for people including：
- Women with no sex between the ages of 12 and 26 are most suitable. Parents and doctors will discuss whether to inject between the ages of 9 and 12.
- Women over the age of 26 can decide whether to inject according to the doctor's recommendation and assessment of financial ability.
- Women who have had sex can only be injected if they have received a negative cervical diaphragm test within one year.
- Men can discuss with their doctors whether to inject according to their sexual activity.
Why does condyloma acuminata grow fast in pregnant women?
When Condyloma acuminata is combined with pregnancy, due to the low immune function after pregnancy and the influence of hormones in the body, especially estrogen, the vaginal mucosa is congested and secretions increase, resulting in the dampness of the vaginal mucosa, which is conducive to the growth and reproduction of papillomavirus.
How to treat condyloma acuminata in pregnant women?
Because it will continue to develop without treatment, traditional topical drugs for the treatment of condyloma acuminata in pregnant women may cause fetal deformities, and freezing, laser, and other treatments may cause miscarriage; therefore, generally speaking, pregnant women should be recommended to terminate their pregnancy after suffering from condyloma acuminate. If a pregnant woman insists on continuing her pregnancy, she can be followed up for observation under the joint treatment of a dermatologist and an obstetrician, and a gynecologist. Once there is discomfort, you should visit the doctor in time. In order to avoid infection in newborns, it is recommended to use transperitoneal cesarean section to remove the fetus during childbirth.
What are the treatment misunderstandings of patients with condyloma acuminatum?
Demanding one-time and thorough treatment and never recurrence, suspecting the spread of the virus in the blood, despair of treatment or even life due to recurrence, only treating warts and not checking other sexually transmitted diseases, only treating oneself and not treating sexual partners or spouses, sex during treatment, excessive drinking and smoking, excessive fatigue at work or entertainment, etc.
How do patients with condyloma acuminata have sex?
Patients with condyloma acuminata should avoid sex during the onset of the disease and during treatment. According to the author's statistics, data on some recurrence cases at home and abroad show that 85% of patients with condyloma acuminata have a recurrence interval of about 1 to 2 months. Therefore, it will not recur within 3 months after treatment. You can wear a condom for sex or listen to the doctor's instructions. Non-recurrence for more than 6 months after treatment can be considered clinically cured, and it is basically possible to have normal sex or listen to the doctor's instructions. However, very few patients may still have the possibility of recurrence for more than 6 months.
What attention should patients with condyloma acuminata pay in their lives to reduce or prevent recurrence?
Go to a regular hospital for early diagnosis and early treatment in dermatology, don't believe smallpox blown by the small advertisement, follow the doctor's instructions for timely follow-up, live asexually during treatment, and bring a sexual partner for diagnosis and treatment at the same time, pay attention to ironing and washing pants and sharing baths, maintain a good routine of life, eat and treat properly, exercise, don't work, don't drink and smoke less. Under the guidance of a doctor, topical preparations of imiquimod can be used for prevention.