Acute condylomas

Pointed condylomas (synonyms: viral papillomas, pointed warts, genital warts) are soft, fleshy, flesh-colored warts that appear on the skin and mucous membranes of the genitals, in the corners of the mouth and perianal area.

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Causes and pathogenesis of genital warts

The causative agent of the disease is the human papillomavirus (HPV), a member of the papovirus family. This is a DNA-containing virus that replicates in the nuclei of epithelial cells. Pointed condylomas are caused by HPV types 6 and 11, less often by types 16, 18, 31 and 31. The last three types are highly oncogenic viruses and also cause precancerous diseases of the genitals and squamous cell carcinoma. Infection occurs through contact, including sexual intercourse. In most patients, the infection is asymptomatic. HPV is latent in the body and is activated only from time to time. Contagiousness is high during periods of exacerbation, when pointed condylomas clinically appear.

Histopathology

Histopathological examination reveals papillomatosis, acanthosis, thinning of the stratum corneum, and areas of parakeratosis. Epidermal cells are vacuolated and their nuclei are pycnotic. In the dermis, there is marked edema, dilation of blood and lymphatic vessels, and chronic inflammatory infiltrate.

Symptoms of genital warts

After an incubation period of several weeks to several years, isolated papules (papillary growths) appear, ranging in size from a pinhead to tumor-like formations, the color of normal skin, pinkish or grayish-red. Gradually, the size and number of elements increase. Papillary rashes merge with each other and form extensive wart-like growths consisting of individual lobules, the base of which is narrowed in the form of a leg. These tumor-like elements take the form of a cock's comb or cauliflower, and have a soft consistency when palpated. When irritated or hygiene is not observed, the elements macerate, can erode, and even ulcerate. The addition of a secondary infection leads to purulent discharge with an unpleasant odor. Pointed condylomas are often located in the area of the external genitalia and anus, but can also be found in other areas (corners of the mouth, red border of the lips, eyelids, conjunctiva). In men, the rash is often localized in the area of the frenulum of the penis, the crown of the head, the external opening of the urethra, the scrotum, the head and neck of the penis. In women, condylomas are located on the labia, labia minora, clitoris, and around the entrance to the vagina. In addition, pointed condylomas can be found in the perineum, urethra, and around the anus.

Pointed condylomas of the anogenital area often recur after surgical excision or laser destruction, which is associated with the latent state of the human papilloma virus, located at the border with normal skin in an area of about 10-15 mm.

Differential diagnosis

Pointed condylomas must be differentiated from secondary recurrent syphilis and malignant neoplasms.

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Treatment of genital warts

For small pointed condylomas, Solcoderm is effective, as well as powders of resorcinol mixed with dermatol, and a 20% alcohol solution of podophyllin, which are applied to each element. Large elements are removed surgically using electro- or laser coagulation. Proteflazit is prescribed at 20 drops 2 times a day as an antiviral and immunocorrective drug. Systemic antiviral drugs are also effective - acyclovir, valtrex, etc. General strengthening treatment is carried out to raise the body's defenses.

Externally, use ridoxol, bonafthon and oxolinic ointments. The effectiveness of therapy is enhanced by using proteflazit in the form of lotions on the affected areas (30-35 drops of the drug per 10 ml of 0.9% sodium chloride solution).