Overview
Warts are sexually transmitted diseases caused by the human papilloma virus, clinically manifested as pointed spikes, the surface of the wet, so the name. Most of the transmission of warts in children is through non-sexual contact, especially in infancy and early childhood, when it is almost impossible for sexual contact to exist, which is the main difference from adults who are mainly infected through sexual contact. However, children can be infected with HPV through sexual abuse.
Causes
The cause of warts is human papillomavirus (HPV), mostly caused by HPV type 6 and HPV type 11 infections. Acromegaly in children is usually caused by the non-sexual route of transmission, and a history of acromegaly in the child’s parents and family members is a major factor in acromegaly infection in children. To summarize the transmission route of acromegaly may be:
1. HPV infection in pregnant women is transmitted to the fetus through the placenta during pregnancy.
2. The fetus is infected by swallowing HPV-containing amniotic fluid.
3. Infants are infected when they pass through a birth canal with acromegaly or HPV infection.
4. Children are infected through close contact in their daily lives with people with condyloma acuminatum or HPV infection, such as their parents, other members of the family, or babysitters, kindergarten teachers, etc. These contacts may be the source of condyloma acuminatum or HPV infection. These contacts may be wart damage, lesion secretions, and HPV-contaminated clothing and towels.
5. Children may also be infected with HPV as a result of sexual abuse.
Symptoms
Children’s condyloma acuminatum may appear as papules, plaques, papillae or cauliflower-like growths, skin-colored or red in color, with a moist surface. The incubation period can range from a few weeks to a few years, with most remaining within 3 months. However, the symptoms of condyloma acuminatum in children may be more pronounced than in adults, and they are susceptible to secondary infections such as bacteria. It has been shown that the younger the child with warts, the longer the child will carry HPV (with or without symptoms). Pediatric condyloma acuminatum occurs mainly in the vulva, urethra, vaginal opening, foreskin and perianal area. Overseas reports of pediatric warts in men are most common in the perianal area.
In addition, pediatric acromegaly is also seen in the throat and mouth and other parts of the body, especially in infants and young children under the age of 3 years old acromegaly almost always occurs in the throat. Pediatric acromegaly occurs mainly in the vocal cords, vocal folds, and laryngeal chambers. Other sites where acromegaly occurs are the gingiva, tongue tie, upper lip, tongue and palate arch and labia majora and minora, urethra, prepuce, and perineum. In addition to the above sites, some pediatric warts have been reported in the umbilicus, buttocks, groin, thighs, neck, ears, hands and feet.
Screening
Pediatric patients with condyloma acuminatum need to undergo acetic acid white test, HPV test, etc. They also need to be examined for sexually transmitted diseases (STDs), especially syphilis, gonorrhea, nongonococcal urethro-genital tract infections, herpes genitalis, chancre, and AIDS.
1. Acetic acid white test
When 3% to 5% acetic acid is applied externally to warts for 2 to 5 minutes, the lesion turns white and slightly elevated; anal lesions may take up to 15 minutes.
2. HPV test
Clinically, serologic techniques are often used to detect HPV antibodies, and polymerase chain reaction (PCR) techniques are used to detect HPV pathogens.
Diagnosis
Diagnosis can be confirmed quickly by typical clinical manifestations. In pediatric patients, acetate whitening can be used to assist in the diagnosis. In addition, HPV can be identified in tissues by electron microscopy and immunochemistry using antibodies to viral microproteins, and in special cases, the virus can be typed by molecular hybridization and cloning techniques to further confirm the diagnosis.
Treatment
1. General treatment
The child should be carefully examined, and disinfection and isolation should be paid attention to.
2. Enhancement of immunity
Children over 3 years old can use Pitomod, etc.
3. Antiviral drugs
Interferon injection should be given within the skin lesions.
4.Removal of warts
Cryotherapy, laser or surgery, or topical medication such as 5% imiquimod cream for children over 12 years old.
5. Psychological management
If the warts are the result of sexual abuse or violence, the child should be counseled.
In most cases, the warts will disappear within a few months after treatment. Because of the high recurrence rate of warts, only by adhering to correct and systematic treatment can subclinical infection and hidden infection of warts be effectively controlled and recurrence be reduced or eradicated.
Preventing
1. If the mother has condyloma acuminatum, she should consider cesarean section to avoid infecting the baby through the birth canal.
2. Babies should avoid contact with patients who have condyloma acuminatum at home.
3. Baby products should be clean.