Candilomatosis (genital warts), its etiology and pathogenesis
The causative agent of candidiasis is a virusHuman papillomavirus (HPV). HPV is pathogenic only for humans. Infection usually occurs during sexual intercourse. The risk group for contracting candidiasis includes people with high sexual activity. Household transmission and infection during medical procedures (including those of medical workers) are also possible. Risk factors include abortions, hormonal disorders, inflammatory processes with vaginal and urethral discharge, skin maceration, poor personal hygiene, and immunodeficiency states.
Clinic, diagnosis, differential diagnosis
Clinic The incubation period continuesseveral weeks/several months. In men, the pathological process is localized on the skin of the inguinal folds, the head of the penis, the outer and inner layers of the foreskin, at the external opening of the urethra, in the perianal area, on the skin of the scrotum. In women, genital warts most often occur on the labia majora and minora, clitoris, skin at the external opening of the urethra, in the inguinal folds, in the perianal area. At first, small, pinhead-sized, single nodules appear. The color is pink or grayish-red. Over time, their number increases. Genital warts grow in the form of papillae, often merging with each other. The resulting tumor-like growths resemble a cockscomb, cauliflower or raspberries. Enlarged genital warts often macerate and ulcerate. A characteristic feature is their lobular structure, which can be easily checked with a spatula or probe. The lobules are soft. As a rule, the surrounding skin is unchanged, but if personal hygiene rules are not observed or if there is constant mechanical irritation, the skin becomes bright red, and a sensation of itching and burning appears. There are also giant condylomas of Buschke-Levenshtein. Diagnostics The diagnosis is made based on the clinical picture and examination of the patient. At the site of the lesion - nodules ranging in size from 1 mm to 1-2 cm. The nodules are not fused with the underlying tissues, soft consistency, pale pink color, lobular structure. Laboratory research methods are used only for differential diagnostics. Differential diagnostics are carried out with secondary recurrent syphilis (wide condylomas) and pyogenic granuloma. Unlike pointed condylomas, broad condylomas have a dense elastic consistency and do not have a lobular structure. In addition, syphilis often has other characteristic signs of the disease. In laboratory studies of broad condylomas, pale treponemas are present in scrapings from the surface. If koilocytic cells are found in the biopsy, this is a characteristic sign of pointed condylomas of the anogenital region.
Treatment, prognosis, complications
The main goal of treatment for men and women isdestruction of condylomas. It is advisable to carry out treatment using several methods at once, since the therapeutic effect may not always be achieved when using only one method. Destruction methods:
The prognosis is favorable for both men and women,but only with timely and adequate treatment. Otherwise, relapses are possible. In men, pointed condylomas on the outer or inner leaf of the foreskin can lead to the development of paraphimosis or phimosis. In men and women, if condylomas are localized in the area of the external opening of the urethra, urination may be difficult, and if they are destroyed, scars may occur that lead to urethral stricture. In case of mechanical damage to condylomas of the perianal area in men and women by feces, bleeding may occur. The most formidable complication in both men and women is the degeneration of a pointed condyloma into a malignant tumor.
