(a) Warts seen in the external genital area in both sexes are treated with topical medications if the individual warts are <5 mm in diameter, the warts in clusters <10 mm in diameter, and the number of warts <15.
(B) Warts in the urethra and perineum in men, vestibule, urethral orifice, vaginal wall and cervical orifice in women, or warts of both sexes that exceed the above criteria in size and number, are recommended to be treated by physical methods.
(c) After physical therapy treatment, there are still a small number of warts remaining on the surface of the body, you can use topical medication again.
(D) whether drug therapy or physical therapy, the need for white acetate test, as far as possible to remove warts damage, in order to reduce recurrence.
Second, topical drugs
(a) 0.5% tincture of ghosts of toxin is the drug of choice. The method is to apply the solution to the warts, medication 2 times a day, for 3 days for a course of treatment. If the warts do not fall off, then after 4 days of rest for the second course of treatment, can be used for three consecutive courses of medication. Adverse reactions are mainly local pain, redness and swelling, no systemic adverse reactions were found. It is prohibited for pregnant women.
(B) 10%-25% tincture of pedicel tincture has been gradually replaced by its purified product 0.5% tincture of onychomycetin due to its greater toxicity. Once a week, each dose should not exceed 0.5 ml, 1-4 hours after the liquid washed away; 6 times with the drug is not cured should be changed to other therapies. Pregnant women are prohibited.
(C) trichloroacetic acid solution Concentration varies from 30% to 80%, which is a chemical corrosive agent that should be used by experienced medical personnel and should not be handed over to the patient for personal use. Once a day, apply the solution directly to the lesions. 6 times of medication without healing should be changed to other therapies.
(d) 2.5%-5% fluorouracil ointment is mainly used to interfere with and inhibit the synthesis of RNA. Topical use 1 to 2 times a day, until the warts fall off, if the surrounding normal skin mucous membrane appears red, swollen, erosion, then should be suspended.
(E) 5% imiquimod (imiquimod) cream
Imiquimod belongs to the non-nucleoside isocyclic amine class of drugs, topical application can play an immunomodulatory role by inducing the body to produce cytokines such as interferon (IFN), tumor necrosis factor (TNF) and interleukin (IL), mainly for the treatment of external genital and perianal condyloma caused by HPV infection. This product is usually used once every other day before going to sleep for a period of up to 16 weeks. Imiquimod does not destroy skin tissue, but can cause erythema, erosion, edema, exfoliation, scaling and itching, burning sensation and other mild to moderate irritation at the site of external application.
(F) Interferon Department of topical interferon through the stimulation of T cells and the suppression of the virus and play a therapeutic effect on small acromegaly. The advantage of topical use is that the drug is not irritating and there is no local redness, pain and other adverse reactions. The disadvantage is that the effect is slow and requires 4 to 6 weeks of continuous topical application. The actual fact is that it is not easy to get a good deal on a lot of the time.
Second, physical therapy
(a) liquid nitrogen freezing with a cotton swab dipped in liquid nitrogen, slightly pressurized placed on the lesions for a few seconds, and so repeatedly. Once a week, several treatments are usually required. Adverse effects include local edema, which can last for several days.
(B) Carbon dioxide laser is suitable for cases with small warts. In the female cervical orifice, male urethral warts are difficult to treat with topical medication, and can be treated with carbon dioxide laser.
(C) photodynamic therapy (PDT) The method is to apply freshly prepared 20% ALA solution to the affected area for 3 hours, and then irradiate with 150mJ/cm2 helium-neon laser for 20-30 minutes continuously. The treatment is carried out at intervals of 1 to 2 weeks and is usually curable in 1 to 3 times. The treatment of urethral warts obtains a cure rate of more than 98%, and the recurrence rate is very low.
(The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things.
The main body of the wart will be removed surgically and the wound will be healed using local medication or freezing. Some patients are too long circumcised, it is recommended to make circumcision.
Third, the system treatment
(a) Interferon 1 million U to 3 million U subcutaneous or intramuscular injections, every other day or twice a week. It has some effect. The immune function is low acromegaly patients can choose.
(B) levamisole in view of the low cellular immune function of some patients with condyloma acuminata, so the use of this drug, there are two oral and external use. The actual fact is that you will be able to get a lot more than just a couple of days to get a lot more than just a couple of days. Externally, levamisole solution is applied to the left front hip flexor side.
(C) other immunomodulators such as transfer factor.
Fourth, the treatment should be noted in several issues
(a) recurrence of condyloma acuminata standard is the disappearance of warts, generally within 3 months after the treatment of the treatment site no regeneration warts that is the basic cure. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things.
(The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. Otherwise, it can cause reinfection of the patient.
(C) male urethral warts treatment is recommended to carbon dioxide laser or photodynamic therapy (PDT) to destroy the warts, a few days later to wait for the wound to heal, topical fluorouracil solution (250mg/10ml injection) drops in the urethral orifice, 1 to 2 times a day.
(d) Treatment of female warts should be done with a speculum with a vinegar white test to check if the cervical epithelium is infected. Since chronic infection with HPV types 16 and 18 can lead to atypical hyperplasia of the cervical epithelium and even the development of cervical cancer, prompt treatment of cervical warts, including damage from subclinical infection, is required.
(E) follow-up treatment
1, for patients who have been basically cured, it is recommended to use topical interferon ointment, 5% imiquimod cream and other drugs with little local irritation and no obvious adverse reactions. The above topical drugs can be applied once a day or every other day for 2 to 3 months.
2, patients with condyloma acuminata should be regularly followed up, generally 2 to 4 weeks once, for 3 months, each follow-up visit should be performed white acetate test. In the complete cure, the patient should be instructed to avoid sexual intercourse.