A6. Skin diseases caused by human papilloma virus (HPV)

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