Human papilloma virus infection

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• Warts (verruca)
  • Histology
    • Hyperkeratosis (hyperplasia of str. corneum)
    • Acanthosis (hyperplasia of epidermis)
    • Papillomatosis
  • Hard papules/plaques
  • Risk factors
    • Immunosuppression
  • Due to HPV
  • Verruca vulgaris (common wart)
    • HPV 1, 2, 4, 7
    • Most common in kids
    • On elbows, knees, fingers, palms
    • Skin-coloured or whitish, rough, scaly papules
    • Cauliflower-appearance
  • Verruca plana (flat warts)
    • HPV 3, 11
    • On face, back of hand, legs
    • Skin-coloured, smooth papules, flat surface
  • Verruca plantaris (plantar warts)
    • HPV 1, 2, 4
    • Soles of the feet
    • Skin-coloured
    • Rough surface
  • Treatment
    • Usually resolves by themselves (can take years)
    • Topical treatment
      • Keratolytics
        • Salicylic acid
      • Retinoic acid
      • Cytostatic
        • Podophyllin
        • 5-FU cream
      • Immune therapy
        • Imiquimod
    • Surgery
      • Cryotherapy
      • Surgical excision
        • Leaves permanent, painful scars
    • Prevention
      • Vaccination
        • Cervarix – 16, 18
        • Silgard – 6, 11, 16, 18
        • Gardasil 9 – 6, 11, 16, 18, 31, 33, 45, 52, 58
• Condyloma acuminata – genital warts
  • HPV 6, 11
  • Exophytic, cauliflower-like lesions
  • In anogenital area or mucous membranes
  • STD
• Giant condyloma acuminatum
  • HPV 6, 11
  • Exophytic wart-like locally invasive squamous cell carcinoma without tendency to metastasize
• Precancerous lesions
  • Vulvar intraepithelial neoplasia
  • Vaginal intraepithelial neoplasia
  • Flat condylomata
    • Flat, white-brown plaques in anogenital region
    • High risk of malignancy
• Anogenital squamous cell carcinoma
  • Vaginal cancer
  • Vulvar cancer
  • Anal cancer
  • Penile cancer