Human papillomavirus (HPV) affects epithelial cells and has a particle diameter of 55 nm. A special feature is the proliferation of the epithelium of the skin, as well as mucous membranes. At the initial stage, the pathogen usually affects the basal cells of the epithelium, penetrating them through microtraumas. Localized papillomas are usually found on the skin of the neck, armpits, groin and genitals (most often), the mucous membrane of the oral cavity and the nasopharynx.
This virus can exist without symptoms for many years. To detect HPV, electron microscopic or molecular hybridization methods are used.
Types of human papillomavirus
Humans have HPV that affects the mucous membranes and skin. Among the large number of papillomaviruses, types with low and high oncogenic risk are distinguished. Oncogenic properties have been shown to be related to the ability of human cells to integrate DNA into their genome.
The virus is activated in 10-20% of cases. Depending on its type, it can cause benign or malignant lesions. Some HPVs are not oncogenic. They cause the appearance of warts and genital warts. The most common are HPV 6 and 11.
HPV oncogenes are those with a high risk of developing cancerous lesions, especially in the cervix or anus. When it comes to the skin, HPV 16 and 18, as well as 5 and 8, which can cause skin cancer, are more common. The most common form of cancer caused by HPV is cervical cancer. However, men can also be infected with the papilloma virus, which in the worst cases causes cancer of the penis or anus.
Most often, women encounter HPV 16 - this is a form in which introsomal parasitism is observed, i. e. outside the cell chromosome (benign). HPV 18 has a high risk of cancer - benign tumors are formed at first, which after some time turn into cancer. In this case, virions have small sizes (up to 30 nm).
- neoplasms of the cervix;
- invasive or pre-invasive oncology;
- genital warts of the urinary tract and genitals.
Features of the infection
Human papillomavirus is highly contagious. It is usually spread by direct contact with an infected person, skin-to-skin or mucosa-to-mucous membrane. For genital infection, this most often occurs during vaginal or oral sex. Having multiple sexual partners or other STIs (sexually transmitted infections) increases the risk. Indirect infection through objects, contaminated clothing or bedding is also possible, but extremely rare.
In 7% of cases, mother-to-child transmission of the virus can occur during childbirth, when the infection is active. When infected with HPV 16 or 18, the risk increases to 40%.
Penetrating the epithelium and breaking its integrity, papillomavirus infection contributes to the growth of the lower layer of epithelial cells in the form of condylomas or warts. This form of the disease is contagious and spreads quickly to others. As a rule, warts and condylomas do not cause metastases and often disappear on their own.
HPV symptoms
The incubation period lasts up to 9 months (3 months on average). HPV can be present in the body without obvious symptoms. The virus can remain undetected for months or years. Even at this stage it is contagious.
Skin warts usually appear in groups and increase in number when scratched. The two most common forms of papillomas are raised with a grayish, hard, broken surface (common wart) or flat and reddish (flat wart). Small warts appear on the soles of the feet or on the heels, grow inward, and therefore are often painful.
- Genital warts. Pale or red nodules that often appear in groups and occur on the labia, vagina, penis, urethra, anal canal, and rectum. They are highly contagious.
- Flat condylomas. They appear as flat nodules and are mostly found in female genitalia. They increase the risk of developing cancer.
- Giant condylomas (Buschke-Levenshtein tumors). They destroy the surrounding tissues and turn into huge formations. In rare cases, they can cause degeneration and squamous cell carcinoma.
Infection of mucous membranes in the upper respiratory tract is also possible. The conjunctiva of the eyes may be affected, resulting in the appearance of pink filamentous growths.
It is more difficult to detect an asymptomatic course, which a doctor can only see with the help of auxiliary tools such as acetic acid (which causes the warts to change color) or a microscope.
In addition, the virus can also inhabit cells without any tissue changes. Then they talk about a hidden infection, that is, the presence of pathogens, but without symptoms. Once infected, this stage can last from several weeks to several months.
Possible outcomes
When infected, viruses penetrate into the cells of the integumentary tissue of the skin and mucous membrane, settle in the nuclei of cell structures and multiply there. Typically, such HPV infections go unnoticed and heal on their own without any consequences, as the immune system successfully fights the pathogen.
However, some types of HPV cause skin changes called growths. Possible forms include genital warts or condylomas and papillomas, which can affect the face, arms or legs, for example.
The resulting tissue changes are mostly benign, but can also lead to degeneration and cancer. For example, cancer can occur decades after HPV infection. Cancer of the external female genital organs (cancer of the vulva and vagina), anal cancer, penile cancer, mouth and throat cancer (tumors of the head and neck) are also possible.
Establishing a diagnosis
As part of preventive visits to the gynecologist, a test for HPV infection is performed in women. During a gynecological examination, a smear is taken from the mucous membrane of the cervix, which is called a Papanicolaou test (cytological examination). The obtained material is studied for tissue changes to determine the precancerous condition.
In addition, an HPV test may be performed, where cell material taken from a mucosa or tissue sample is tested in a laboratory for the presence of certain viruses. However, this only proves that the affected area is infected, but does not reveal whether tissue changes have occurred. Thus, HPV testing makes sense, especially when combined with a Pap test, and can help detect cancer precursors at an early stage.
If the test is positive, there is no reason to worry, because infections do not always lead to cancer. Regular examination is recommended to detect tissue changes at an early stage. Conversely, a negative test result does not indicate whether there is a past infection that the body has successfully fought off.
For men, there is no preventive screening for which the test should be performed regularly. If there is an underlying cancer, examining the tumor can determine whether HPV infection is underlying the cancer.
Specialized DNA methods such as real-time PCR are also used in laboratory diagnostics. Anogenital warts caused by HPV types 6 and 11 are easily detected during a gynecological examination.
How to treat human papillomavirus
In most cases, the disease does not require treatment, because it goes away on its own, and then the viruses are no longer detected. However, if this is not the case, the infection may take longer and last for months or years.
To date, there are no systemic methods of effecting this virus that can completely destroy it. However, treating existing warts reduces the number of viruses, so in many cases the immune system can fight off the remaining viruses and thus get rid of them. In some cases, pathogens survive and can cause symptoms of the disease again and again.
- Plantar and genital warts can be treated with salicylic acid topical medications.
- Cryotherapy is also a commonly used method for HPV. In this case, the wart is burned with cold using liquid nitrogen.
- Lasers or electrocautery are equally used methods.
Cancer caused by HPV is more difficult to treat. For cervical cancer, it is often recommended to remove the uterus, and the upper part of the vagina and ovaries, respectively. This can be supplemented with radiation therapy to eliminate the possibility of relapse. Other cancers caused by HPV are most often treated with targeted therapy, such as radiation or chemotherapy.
It should be remembered that the operation is not a radical solution, it only solves the cosmetic problem, because after removal, the virus can remain in the surrounding tissues and condylomas can reappear.
Prevention of infection
There are two vaccines: the bivalent vaccine against HPV 16 and 18 and the quadrivalent vaccine against HPV 6, 11, 16 and 18. The vaccine is recommended for all young girls age 14 and older.
The vaccine does not protect against all types of HPV. Therefore, all women between the ages of 25 and 65 are recommended to have regular Pap smears, even if they are vaccinated.
Timely detection and complete removal of condylomas reduces the risk of disease. The effectiveness of using condoms to protect against the transmission of infection can significantly reduce the risk of developing this disease. The most promising way to prevent and treat the initial stages of the disease caused by this infection is a specific polyvalent vaccine.
Why do plantar warts appear and how to treat them
Warts are skin lesions that appear in the form of special round formations that protrude above the surface. They are caused by specific viruses.
These formations often cause physical discomfort due to their location. They are repeated even after treatment.
Types and causes
There are many types of warts, they are classified according to a number of characteristics:
- Simple. They are found on exposed parts of the body, arms, legs, face and scalp. They are usually not dangerous, but they are not aesthetically pleasing and can multiply quickly, affecting large areas of the skin. They are arranged in "families".
- Plantar. Their localization is only on the feet. It causes discomfort while walking.
The main cause is infection with the human papillomavirus, which affects the mucous membranes and skin.
Human papillomavirus
It is one of the most common viruses on earth. Infection can occur in several ways:
- communication and domesticity (through touch);
- sexual (genital, anal, oral-genital);
- from mother to child during birth.
The development period of the disease is from several weeks to ten years, which is explained by the fact that the virus does not manifest itself for a long time, but after the immunity weakens a little, growths appear immediately. skin and/or mucous membranes. The main danger of this disease is that certain types of HPV are more likely to cause the formation of a malignant tumor (cancer of the skin or mucous membranes). To be sure that the disease will not lead to the formation of a tumor, it is necessary to undergo a doctor's examination and not self-medicate.
Symptoms and types of warts on the feet
A plantar wart appears as a callus-like thickening of the stratum corneum layer of the skin. It interferes with walking and causes pain. The passive state is characterized by slow reproduction that does not reach the corneum layer of the epithelium, so this state does not manifest itself externally.
The active state is characterized by the rapid development of the virus and its rise to the upper layers of the epidermis, manifesting itself in numerous symptoms. Plantar wart is also called spinous wart, chicken wart. The virus enters through cuts and abrasions in the outer layer of the skin during skin contact:
- First, a small yellowish-gray papule with an uneven surface appears.
- Gradually, the small element becomes dense and acquires a dirty color.
From the inside, a plantar wart looks like melted papillae of different sizes of pink color. Additional capillaries are formed there, and if you get a wart, it will cause bleeding.
Removal of plantar warts
It is worth treating a plantar wart if:
- There are painful feelings.
- The wart is bleeding.
- There were spots on it.
- A wart grows rapidly in size.
There are many treatment methods. One of them is cryodestruction. The meaning of the method is that the wart is exposed to liquid nitrogen at a temperature of minus 196 degrees. The area affected by the virus is frozen and the wart is removed.
A conventional and aggressive exposure method is used. With the aggressive method, nitrogen is applied for a few seconds longer, but this method is more painful. It should be noted that if a wart appears and exists for more than six months, then the effectiveness of cryodestruction is greatly reduced and, accordingly, the meaning of such an operation disappears.
After removing a plantar wart using liquid nitrogen, you should follow some recommendations:
- the blister remaining at the site of the wart cannot be opened;
- to avoid mechanical damage, use a sterile bandage rather than plaster;
- Treat the affected area with 2% salicylic alcohol twice a day;
- try to prevent water from entering the affected area.
Another method is laser coagulation. This is one of the most common ways to remove warts. Most laser systems are equipped with a special cooling system. Thus, the procedure takes place with minimal discomfort and does not allow inflammation, as the laser has antiseptic properties. Moreover, it is a non-contact method.
There are several ways:
- Carbon dioxide (CO2) laser. In this case, the treatment takes place using infrared light. The method is 70% effective, but the downside is that healthy tissues can also be damaged.
- Erbium laser. This treatment method uses a shorter wavelength, which reduces the possibility of scarring after surgery. Efficiency is usually 75%.
- Pulsed dye laser. With this method of exposure, the initial destruction of enlarged capillaries in the wart and stimulation of the immune system, which contributes to effective treatment. The effectiveness of the treatment is about 95%.
After laser treatment, a crust forms on the affected area and disappears on its own within seven to ten days. The recommendations for this method of treatment are the same as after exposure to nitrogen - avoid mechanical damage and ingress of water.
The next way to remove warts is electrocoagulation. At this time, a high-frequency current is applied to the wart. Treatment is performed under local anesthesia. Exposure of a wart to high temperature causes the cells affected by the papilloma virus to vaporize. Another advantage of this method is that cauterization of veins prevents bleeding. After the operation, a crust is formed on the affected area of the skin, which disappears within 7-10 days.
Plantar warts can be treated directly with surgery. In this case, the incision is made under local anesthesia, and then stitches are applied. After the operation, the doctor will give certain recommendations. Thus, in the first 7-10 days, it is recommended to prevent water and soap from entering the affected area, not to tear off the resulting crust, and to treat the affected area with an antiseptic.
There are certain contraindications for each type of operation. Therefore, the transaction will not be able to be performed if the following occurs:
- pregnancy;
- diabetes;
- malignant tumors in the body;
- infection and inflammation around the wart;
- exacerbation of herpes;
- elevated temperature.
If you have high blood pressure, the procedure should also be postponed.
Treatment of warts without surgery
People often wonder how to remove plantar warts without surgery. For this, you can use pharmaceutical ointments and solutions.
Basically, these ointments have the following effects:
- anti-inflammatory;
- antiseptic;
- immunomodulator;
- antiviral;
- antifungal.
In addition, it may contain vitamin E, which has a positive effect on treatment, because vitamins generally strengthen the body and reduce the risk of relapse.
It is important to use these products for single and shallow plantar warts. Moreover, if any side effects occur, wash the medicine with plenty of warm water and consult a doctor immediately.
So, it is possible to treat warts, there are many ways to do this, but in order not to harm your health, you should not do it without consulting a doctor first. In addition, self-medication is strictly prohibited if the attending physician prescribes contraindications.
Treatment of papillomas on the body
Hardware methods
Modern hardware methods for the treatment of papillomas allow to get rid of them and prevent the relapse of the disease. The most commonly used methods are:
- Cryodestruction is the destruction of growths by exposure to low temperatures.
- Electrocoagulation is the burning of formations with an electric current, the strength and frequency of which is selected depending on the size, type and density of the papilloma.
- Laser removal. The type of effect is obvious from the name. The procedure takes no more than 15 minutes and helps to get rid of unpleasant growths forever.
Drug treatment
Medicines used include celandine, castor oil, lapis lazuli, Sani Skin and Dermavit preparations.
They show different effectiveness and do not prevent the recurrence of the disease. The main drawback of drug treatment of papillomas is the frequent development of allergic reactions.
Prevention of papillomas
In order for the growths not to appear and not to be infected with the human papillomavirus, you should do the following:
- Use barrier contraception during sexual intercourse.
- Follow the rules of personal hygiene and use only personal towels, soap and toothbrush.
- When visiting public baths, do not neglect to wear rubber shoes.
You should also normalize your daily routine, eat a balanced diet, give up bad habits and avoid stressful situations. These factors are not the cause of the disease, if the virus is already in the body, it can cause its development.