Genital warts, also known as condyloma acuminatum, the most common sexually transmitted disease, are genital perianal proliferative lesions caused by Human papillomavirus infection (HPV).
It mostly occurs in young people between the ages of 18 and 35. The disease mainly transmitted through direct sexual contact and can also spread by vertically transmitted infection and indirect contact.
Genital warts causes
- The pathogen of the disease is human papillomavirus (HPV). It is a small DNA virus with a diameter of 55 nm, a lipoprotein-free envelope, consist of 72 virus shells. Its genome is a circular double-Strand DNA. It has a molecular weight of 50000 kD.
- HPV has been classified into more than 100 subtypes by modern molecular methods. HPV can produce different types of damages in your, such as condyloma acuminatum, flat warts, common warts, and Bowen’s disease. Additionally, there are 34 types of virus link with this disease, the most common being HPV 6, 11, 16 and 18. The human body is the only natural host of HPV.
- HPV is prone to warm and humid conditions, so it is easy to occur in the external genitalia and perianal. The transmission of genital warts is through direct sexual contact and can spread by a vertically transmitted infection, i.e. from infected mother to a baby, and indirect contact.
- The incubation period of the disease is 1 to 8 months, with an average of 3 months. It mainly occurs in sexually active people with young people aged 18 to 35 years old, accounting for more than 80%. The external genitalia and perianal are the common areas of the disease. Female vaginitis and male foreskin are auxiliary factors for the occurrence and growth of this disease. In Male, it occurs in the coronary sulcus, glans, foreskin, ligament, penis, perianal and scrotum. In the woman, spots of HPV infection occurs in the labia majora, posterior vestibule, cervix and perianal.
- At the beginning of the skin lesion, it is a small and reddish papule, which gradually increases. The surface is uneven and rough and usually has no special feeling. Meanwhile, it gradually grows like a ridge and spreads other parts of the body. Sometimes, it causes foreign body sensation, itching and sexual pain, bleeding and exudation.
Genital warts Diagnosis
- HPV infections mostly found in slightly wet parts of the body such as genitals or perianal, and the surface is rough and keratinised. Medical practitioner diagnoses HPV virus with the help of a laboratory test. Additionally, another most sensitive method of detecting a virus is Nucleic acid hybridisation.
- The disease should be differentiated from other proliferative conditions of the external genitalia and perianal, skin diseases and normal physiological structures. For example penile pearly papules, villi labyrinthine, flat warts, Bowenoid Papulosis, squamous cell carcinoma and sebaceous Hyperplasia.
Genital warts Treatment
- Topical drug treatment: Currently, commonly used drugs are forage, trichloroacetic acid, imiquimod, Fluorouracil Topical.
- Physical therapy for HPV mainly includes laser treatment, liquid nitrogen cryotherapy, electrocautery treatment and Segmental resection.
- Aminolevulinic acid photodynamic therapy (ALA-PDT therapy) can selectively kill and reproduce the cells. It can damage the visible condyloma acuminatum and remove the infection. The cure rate is high, the recurrence rate is low, the adverse reactions are few and slight, and the patient compliance is good.
- Immunotherapy: Medical practitioner use this therapy as an auxiliary treatment for the above treatment method. Commonly used immunotherapy mainly includes interferon and interleukin-2.
Treatment of genital warts in pregnant women
- Pregnant women with genital warts should treat the infection as early as possible in the early stages of pregnancy. If there are skin lesions during childbirth obstructing the birth canal, or vaginal delivery, it can cause severe bleeding. On the other hand, Podophyllotoxin, Valerate and Fluorouracil have teratogenic effects and can disturb the development of the embryo or fetus.
- Above all, pregnant women can choose 50% trichloroacetic acid solution for external use, laser treatment, cryotherapy or surgical treatment. Condyloma acuminatum is not an indication of termination of pregnancy.