HPV or human papillomavirus is the most common infection in the world. According to researchers, more than 90% of people around the world are infected with one type of HPV or another. Currently, there are more than 70 varieties of human papillomavirus, but only some of them are of interest to doctors.
HPV belongs to the genus of papillomaviruses from the family of papovaviruses. The source of infection is a sick person or a virus carrier, that is, HPV is transmitted only from person to person.
There are three ways of transmission of this infection:
- contact-household (through touch);
- sexual (genital, anal, oral-genital);
- in childbirth from mother to child.
HPV affects the skin and mucous membranes: they form various warts, papillomas and condylomas.
The virus lives in human blood and until a certain time does not manifest itself. But as soon as the immune system is weakened, growths appear on the skin and / or mucous membranes. This explains a rather long incubation period: from several weeks to tens of years.
Conventionally, all types of HPV can be divided into 2 groups:
HPV, “guilty” in education warts;
- HPV 1,2,3,4 types cause the formation of plantar warts or corns.
- HPV 3,10,28, 49 types are responsible for the appearance of flat warts.
- HPV type 27 forms “warts butchers.”
- Various warts also cause HPV types: 5, 7, 10, 12, 14, 15, 17, 19-24, 26, 27, 29, 57.
HPV, “guilty” in development papilloma and condyloma;
- HPV 6.11, 13, 16, 18, 31, 33, 31, 33, 58, 52, 39, 70, 30, 40, 42, 43, 51, 55, 57, 59, 61, 62, 64, 67 -69 types cause the formation of papillomas and genital warts.
What is the danger of HPV?
HPV can cause a malignant tumor (cancer of the skin or mucous membranes). There are 3 types of its oncogenicity:
- HPV at low risk of cancer: 6, 11, 40, 42, 43, 44, 54, 61, 70;
- HPV risk of oncological risk: 26, 31, 33, 35, 51, 52, 53, 58, 66;
- High-risk HPV: 16, 18, 36, 39, 45, 56, 59, 66, 68.
Table: Compliance with HPV Type Disease
|Warts on sole of the foot (corns)||1, 2, 4|
|Common warts||2, 4, 26, 27, 29, 57|
|Flat warts||3, 10, 28, 49|
|Veruciform epidermodysplasia||2, 3, 5, 8, 9, 10, 12, 14, 15, 17, 19, 20-25, 36, 37, 46, 47, 50|
|Lesions of mucous genital organs:|
|Genital warts||6, 11, 42-44, 54|
|Epithelial lesions without germination in other layers ( intraepithelial lesions) may be a precancerous condition||6, 11, 16, 18, 30, 31, 33?, 39, 40, 42, 43, 51, 52, 55, 57-59, 61, 62, 64, 67-70|
|Cancer of the cervix, vulva, vagina, anal area and penis||16, 18, 31, 33, 35, 39, 45, 51, 52, 54, 56, 66, 68|
|Lesions of non-genital mucous membranes:|
|Lesions of the oral mucosa (focal epithelial hyperplasia)||13, 32|
|Recurrent airway papillomatosis||6, 11, 30|
|Malignant formations of the head, neck, lungs||2, 6, 11, 16, 18, 30|
The most common clinical form of HPV. At first they look like dome-shaped papules, the dimensions of which do not exceed the pinhead. Then they begin to grow and at the same time darken, their surface becomes rough. Around the maternal warts are formed children, during this period pain and burning are possible.
Warts are located on the back of the hands and feet, in the chin area, on the eyelids, on the scalp, between the fingers, on the sole.
Plantar warts are painful, because of them a person cannot walk. Low oncogenic risk.
This type of warts looks like a cutaneous horn (long filiform papules). As a rule, they are localized on the hands and fingers of the hands, often occur at the site of cuts. Called HPV 2 and 7, it is a benign formation, not prone to rebirth.
Such warts slightly rise above the level of the skin, have a tendency to group. The color of flat warts is flesh-colored or pale brown, located on the forehead and shoulders. They can be located on the penis, cervix, external genitalia and anus.
Hereditary disease. It is very rare in the form of dermatosis. Looks like a lot of flat warty rashes or pigmented spots. Scaly rashes, merge among themselves, localized on the face, neck, upper limbs. In appearance, the disease is similar to pityriasis versicolor. Perhaps a rebirth in cancer. It is called HPV 2, 3, 5, 8-10, 12, 14, 15, 17, 19, 20-25, 37, 47, 50 types.
Localized on the sides of the nail, grow into the skin and lead to dystrophy of the nail plate. Not prone to malignancy.
It looks like a single formation only in the upper layer of the epidermis (usually on the head). A lesion from 5 to 50 mm looks like an expanding stratum corneum, sometimes crusted. Called HPV type 16. The formations are prone to degeneration into squamous cell carcinoma.
The appearance of the formations resembles a cauliflower or cockscomb. Most often the condylomas are located on the foreskin, the head of the penis, near the urethra, around the anus, on the labia minora, on the vaginal mucosa, the cervix, in the corners of the mouth, at the mouth of the urethra.
Education in the oropharynx.
- Flowering papillomatosis in the oral cavity also resembles a cauliflower in appearance: white plaques on the oral mucosa. Occurs in older people. Laryngeal papillomatosis can descend on the trachea, bronchi and lung tissue, occurs in children and adults. Signs of laryngeal papillomatosis are dysphonia (speech disorder) and aphonia (inability to speak), hoarseness and difficulty breathing. With the defeat of the oropharynx HPV may occur cancer.
HPV cannot be removed from the body, so all methods of therapy are reduced to the elimination of external manifestations, that is, to the destruction of formations.
Destructive treatment methods have different efficacy and do not guarantee that the papillomas / warts will not reappear. These methods include:
- surgical excision of the wart / papilloma (used only in cases of suspected malignancy );
- electrocoagulation – cauterization of the formation of a coagulator, through which an electric current passes;
- cryodestruction – destruction of the wart with liquid nitrogen;
- laser therapy – the effect on the formation of a laser beam;
- radio wave method – impact on the wart / papilloma using the apparatus ” Surgitron “.
- cautery salicylic acid;
- treatment of the formation of trichloroacetic acid 50-90% concentration;
- contactaris – application of the drug for education for a period of 24 hours;
- Solkoderm (mixture of acids) – treatment with a preparation of education (efficacy is very low).
Use of cytostatic drugs:
- podophyllin in the form of a 10-25% alcoholic solution;
In order to increase the effectiveness of treatment, combination therapy is carried out, which consists in the local removal of the formation and the effect of nonspecific antiviral and immunomodulating drugs systemically. In this case, suppression of HPV activity is achieved, and even its complete destruction. These drugs include:
- allelocin- alpha has antiviral and immunomodulatory effects, intramuscularly injected;
- Viferon (a group of interferons) is used as an ointment, gel or in rectal suppositories;
- genferon (interferon group) in the form of vaginal and rectal suppositories;
- isoprinosine has an immunostimulating effect, is used in the form of tablets inside;
- Immunomax refers to immunomodulators, intramuscularly injected;
- Likopid has an immunomodulatory effect, is available in tablets for oral administration;
- Epigenum intima has immunostimulating, antiviral, anti-inflammatory, antipruritic and healing properties, is available as a spray for external treatment.