It is a sexually transmitted disease caused by human papillomavirus infection. It is transmitted mainly through sexual intercourse and sometimes through indirect contact (contact with objects used by the patient). It is one of the most common sexually transmitted diseases.
Etiology: There are more than 100 subtypes of human papillomavirus (HPV) that have been identified to date. The main types that cause condyloma acuminatum are 6 and 11, and the rare ones are 16, 18, 31, 33 and 35. The rare subtypes are related to anal genital cancer, so they are called high-risk types.
Clinical manifestations
Incubation period: generally 1-8 months, with an average of 3 months.
Site of onset: Mostly seen in the genital and anal areas, and rarely seen in areas other than the anogenital area, such as the oral cavity, armpit, breast, and interdigital toe.
Skin lesions: There are various manifestations. The surface is rough, granular or finger-like, raised redundant; papular manifestation; macular manifestation. A few warts overgrow and become giant, sometimes malignant.
There are usually no conscious symptoms.
Subclinical infection: difficult to determine with the naked eye, positive white acetate test. Latent infection: normal appearance, negative white acetate test, and the presence of human papillomavirus can be detected by molecular biology methods (HPV nucleic acid test). Subclinical infection and latent infection are associated with recurrence.
Diagnosis and differentiation
Diagnosis: It is mainly based on history (history of STD exposure or indirect exposure), clinical manifestations and can be combined with the results of white acetate test. HPV nucleic acid test (PCR) is not a necessary test for diagnosis, but can be done when there is difficulty in diagnosis and when virus typing is needed.
Differentiation: It needs to be differentiated from pseudomonal warts in women, pearly penile papules in men, sebaceous ectopia, and from lichen planus and Bowen-like papulosis. Pseudomonal warts, penile pearly papules, and sebaceous ectopia are related to local chronic inflammation, friction, and physiological variation, so don’t treat them as STDs.
Treatment
Topical medications
(1) 0.5% tincture of haematoxylin. Use 3 days stop 4 days for a course of treatment, available for 1-3 courses of treatment. Apply to any area. The teratogenic effect should be noted, so pregnant women are prohibited.
(2) 5% Imiquimod cream. Once a night, 3 times a week for 16 weeks. There is also a certain effect of preventing recurrence. It is irritating to skin and mucous membrane.
(3) Others: e.g. 50% trichloroacetic acid, 5% 5-fluorouracil, etc.
Physical therapy: laser, freezing, electrocautery, microwave, etc. Giant condyloma acuminata can be treated surgically.
Internal drug treatment
(1) Interferon (systemic and intra-wart injection), BCG polysaccharide nucleic acid injection, etc.
(2) Chinese medicine treatment. Our homemade hustle and sound combination has certain therapeutic effect on various viral warts.
Photodynamic therapy
It is a new treatment based on the interaction of light, photosensitizer and oxygen.
It has the advantages of less damage, elimination of hidden lesions (latent and subclinical infection), reduction and prevention of recurrence. It can be used for the treatment of specific areas such as the urethra, the prepuce, the intravagina and the cervical os, and has advantages over other methods in reducing recurrence and shortening the treatment course. The disadvantage is that it is more expensive.
Treatment precautions
(1) It is important to check for other STDs such as syphilis, AIDS, gonorrhea, etc.
(2) Sexual partners and spouses should be examined and treated.
(3) Regular follow-ups are required during and after treatment. Recurrence may occur during the process, but complete removal of warts is a matter of time.
(4) The skin lesions can be judged as cured after 3-6 months of cessation of attacks.