1. What are the symptoms and dangers of HPV infection?
Some patients found some new organisms in the vulva or vagina, and then went to the hospital for examination and found that it was due to HPV virus infection, so what are the symptoms of HPV virus infection?
Some patients find unexplained new biological protrusions on the vulva, and some protrusions grow quickly, some slightly slower, and are contagious, and some couples or sexual partners have similar conditions, which are often referred to as condyloma acuminata, papilloma, Bowen’s disease of the vulva, Bowen’s papules and so on. There are also some patients who do not have any symptoms, but now medical experts have found that part of the HPV virus is the culprit of cervical cancer, and this part of the patients may not have any symptoms, and can only be detected by HPV virus screening.
2.How to treat HPV infection?
Since the disease is self-limiting and easy to recur after treatment, and there is no method to eradicate HPV, therefore, although there are more treatment methods, the treatment is mainly to remove local proliferative warts, and the basic principle is still to be effective, easy, safe and not to cause scars when choosing. For subclinical infection area, under the instruction of white acetate test, can be treated at the same time according to the treatment of clinical infection; for latent infection, whether to treat or how to treat? There is no uniform view yet.
In addition, sexual partners and other sexually transmitted diseases that may accompany them should also be treated promptly and effectively. It has been observed that patients with acromegaly combined with other sexually transmitted diseases have a higher recurrence rate, in addition to taking protective measures to avoid transmission to others.
(i) Topical treatment
The most common method is to use the most effective, if the appropriate use of combined therapy, can achieve more satisfactory results.
1, 0. 5% of the tincture of ghost mortar toxin (trade name: You De Xin, warts enemy) can inhibit epidermal cell mitosis, and cause tissue necrosis, and small side effects. Before using the drug to clean the affected area, wipe dry, apply the drug twice a day, 3 days for a course of treatment, repeat the drug need to interval of 4 days or more than 4 days. The cure rate of the first course is 54.8%, the cure rate of the second course is 32.1%, the cure rate of the third course is 13.1%, the main side effects are local mild erythema, edema, erosion, and pain.
2, 10% to 25% of the foot leaf fat benzoin tincture (or ethanol liquid) mechanism of action with the ghost mucus toxin, but the irritation is large, can cause systemic absorption of toxic reactions. Before applying the drug need to use petroleum jelly to protect the normal skin mucous membrane, 2 hours after applying the drug with soapy water to wash the affected area, once a week, each time the dosage should be limited to 0.5ml or less, the area used less than 250px square. Pregnant women and children are prohibited.
3. 5% 5-Fluorouracil (5-FU) blocks DNA synthesis by blocking the methylation of thymidine glycosides synthesized by deoxyuridine acid, and inhibits the replication of virus. Apply topical ointment, cream or seal with impermeable adhesive tape, change once in 24 hours for 4 weeks, while taking care to protect normal skin. For the treatment of male urethral warts, inject 12 ml of cream with a nozzle or apply with a cotton swab 4 times a day after the bladder has been emptied to avoid adhesions. For vaginal warts will be 5% of the drug soaked gauze, plugged into the vagina, 2 hours to remove.
4, 25% to 50% trichloroacetic acid solution has a chemical exfoliation, hemostatic and sword collection effect. Once a day, for 4 to 6 days, interval of 1 week can be used again. The solution can only be applied to the wart, and use talcum powder or sodium bicarbonate powder to remove the acid that has not reacted.
5, 3% phthalamide ointment is a kind of aldehyde ketone shrink thiourea derivatives, the viral skin disease has satisfactory effect. Topical application 2~3 times a day, 4 weeks course of treatment.
6.5％ acyclic guanosine ointment inhibits the replication of viral DNA. 3 times a day.
7, Su high treatment skin (solcnderm) is a compound topical preparation containing nitric acid, acetic acid, lactic acid, oxalic acid and other acids. Use the coating stick point in the whole wart 1-3 times, until it becomes gray or slightly yellow, 3-5 days to review, can repeat 1 time.
8, the compound geranium oil is a containing geranium and crow’s nest and a variety of Chinese medicine volatile oil and extracts, with the exfoliation and stimulation of warts tissue. Apply 3 times a day, pay attention to protect the surrounding normal skin mucosa, 2 weeks for a course of treatment, every other week can be used again 1 course of treatment.
9, dinitrochlorobenzene (DNCB) through sensitization to stimulate the local delayed hypersensitivity reaction. The local burning sensation and eczema-like reactions are heavy after use, and may have potential carcinogenicity, so it should be used with caution. Some authors recommend using it in combination with laser, etc., and obtain more satisfactory results.
(II) Physical therapy
1.Laser Use its thermal effect to make the lesion tissue vaporize due to high temperature. The CO2 laser can be used to treat any part of the warts. the Rb-YAG laser is particularly suitable for warts in the proximal 2/3 of the urethra and some mucosal damage. The CO2 laser is used to treat warts, while the CO2 laser superficial coagulation method is used to treat subclinical infections and warts around the 50px range, which can reduce the recurrence of warts.
2, electric cautery or electric drying make cell denaturation, necrosis, to remove warts, patients with pacemakers or close to the anal edge of the warts, prohibit electric drying method.
3, freezing general use of liquid nitrogen, but also with CO2 dry ice, so that the necrosis of warts tissue to last until all the lesions frozen ice ball, the base to see a frozen skin halo so far. Freezing range extended to the warts around the 1-50px normal skin is more effective. The mucous membrane should be frozen with special care to prevent serious complications such as ulcers.
4, isotope: 90Sr each time 5Gy, a total of 5 times, after each 10Gy, to 55Gy for a course of treatment.
5, microwave local anesthesia, with the treatment instrument of the needle-like radiation pierced into the base of warts. Microwave output power 40-50W, each point lasts 2 seconds, see the tissue coagulation white, superfluous removed.
(C) Surgical treatment
1, surgical excision Should be used for larger damage, but easy to recur. And attention should be paid to reduce the formation of scars. It is believed that circumcision of patients with long foreskin can help prevent or reduce the recurrence of acromegaly.
2, scraping routine disinfection, to 2% procaine to perform basal anesthesia, then use a surgical scraper to quickly scrape the warts, pressure to stop bleeding and immediately coated with 40% trichloroacetic acid.
3.Cutting method is used to treat less than 4 warts and lesions less than 10mm in diameter. The perianal or anal canal warts are more effective. Under local anesthesia, along the base of the wart to cut out the wart, from the back to front cut, in order to avoid exudate and blood affect the surgical process.
(iv) local injection
1, interferon with antiviral, anti-proliferative and immunomodulatory effects. Recommended with а-2a genetic engineering interferon treatment, to 1 million U with water for injection or saline 0.5 ~ 1ml dilution, uniform injection in the base of each lesion, every other day injection, 3 times a week, a total of 9 times injection.
2.Constitutinomycin inhibits DNA synthesis and partially inhibits RNA synthesis. Inject 0.1% solution into the base of the wart, each time the total amount is limited to 1ml.
3, 5 a fluorouracil routine sterilization, the drug solution 125mg injected into the base, and then ointment external to the wart body.
(V) systemic treatment
At present, most of them are used in combination with local treatment, which can play a supplementary therapeutic role. You can use polymyxin, interferon, thymidine (vegetation), virazole, daily or every other day intramuscular injection, or local damage parts for subcutaneous injection. It can also be used orally such as chamomile polysaccharide. The efficacy of levamisole is debated.
(F) pregnant women acne
According to the survey, the prevalence of pregnant women is 1.5% to 2.5%, another person reported that pregnant women warts accounted for 11.33% of female patients.
If the warts are large and obstruct the birth canal or cause hemorrhage, cesarean section is preferred; cesarean section is not recommended to prevent HPV infection in newborns. Note that newborns can be infected with the virus through the birth canal, and there is a possibility of causing laryngeal papillomatosis in newborns.