Human papillomavirus (HPV) affects epithelial cells and has a particle diameter of 55 nm. A peculiarity is the proliferation of the epithelium of the skin, as well as of the mucous membranes. In 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 nasopharynx.
This virus can exist for many years without symptoms. To detect HPV, methods of electron microscopy or molecular hybridization are used.
Types of human papillomavirus
In humans, there is HPV that affects 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 to integrate DNA into the genome of human cells.
The virus is activated in 10-20% of cases. Depending on its type, it can lead to benign or malignant lesions. Some HPVs are not oncogenic. They lead to warts and genital warts. The most common are HPV 6 and 11.
HPV oncogenes are those that have a high risk of developing cancerous lesions, especially of the cervix or anus. When it comes to the skin, HPV 16 and 18 are more common, as well as 5 and 8, which can lead to skin cancer. The most well-known form of cancer caused by HPV is cervical cancer. But men can also become infected with the papilloma virus, which in the most severe cases causes cancer of the penis or anus.
Often, women encounter HPV 16 - this is a form in which intrasomal parasitism is observed, i. e. outside the cell chromosome (benign). HPV 18 has a high risk of developing cancer - first benign tumors are formed, which after some time degenerate into cancer. Virions in this case have small sizes (up to 30 nm).
- neoplasms of the cervix;
- invasive or preinvasive oncology;
- genital warts on the urinary tract and genitals.
Characteristics of the infection
Human papillomavirus is highly contagious. It is usually transmitted by direct contact, skin-to-skin or mucosa-to-mucosal, with an infected person. For a genital infection, this most often occurs during vaginal or oral intercourse. Having a large number of sexual partners or other STIs (sexually transmitted infections) increases the risk. Indirect transmission through objects, contaminated clothing or bedding is also possible, but is quite rare.
In 7% of cases, transmission of the virus from mother to child can occur during childbirth, when the infection is active. The risk increases to 40% when infected with HPV 16 or 18.
Penetrating the epithelium, disrupting its integrity, the papillomavirus infection promotes 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 among others. As a rule, warts and condylomas do not metastasize and often disappear spontaneously.
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 go undetected for months or years. Even at this stage it is contagious.
Skin warts usually appear in groups and enlarge when scratched. The two most common forms of papillomas are either greyish, hard, raised with a broken surface (common wart) or flat and reddish (flat wart). Prickly warts appear on the soles of the feet or heels, grow inward, and are therefore often painful.
- Genital warts. Pale or reddish nodules that often appear in groups and appear on the labia, vagina, penis, urethra, anal canal, and rectum. They are highly contagious.
- Flat condylomas. They appear in the form of flat nodules and are found mainly on the female genital organs. They increase the risk of developing cancer.
- Giant condylomas (Buschke-Levenstein tumors). They grow in huge formations, destroying the surrounding tissues. In rare cases, they can degenerate and lead to squamous cell carcinoma.
An infection of the mucous membranes in the upper respiratory tract is also possible. The conjunctiva of the eyes may be affected, resulting in the appearance of pink stalks.
It is more difficult to detect an asymptomatic course, which the doctor can only see with the help of aids such as acetic acid (causes discoloration of warts) or a microscope.
In addition, the virus can take up residence in cells without any tissue changes. Then they talk about a latent infection, that is, the presence of pathogens, but without symptoms. Once infected, this phase can last from several weeks to several months.
Possible consequences
When infected, the viruses penetrate the cells of the covering tissue of the skin and mucous membrane, settle in the nuclei of the cell structures and multiply there. Usually, such HPV infections go unnoticed and heal on their own without consequences, as the immune system successfully fights the pathogen.
However, some types of HPV create skin changes called growths. Possible forms include genital warts or condylomas and papillomas, which can affect the face, hands or feet, for example.
The resulting tissue changes are mostly benign, but can also degenerate and lead to cancer. For example, cancer can occur decades after an HPV infection. Cancer of the female external genitalia (cancer of the vulva and vagina), cancer of the anus, cancer of the penis, and cancer of the mouth and throat (tumors of the head and neck) are also possible.
Establishing a diagnosis
The test for HPV infection is carried out in women as part of the preventive visits to the gynecologist. During a gynecological examination, a smear is taken from the mucous membrane of the cervix, this is called a Papanicolaou test (cytological examination). The resulting material is examined for tissue changes to determine precancerous conditions.
In addition, an HPV test may be done, in which cellular material from a mucosal swab or tissue sample is examined in a laboratory for the presence of certain viruses. However, this only proves that the affected area is infected, but does not make any statements as to whether tissue changes have occurred. Thus, the HPV test makes sense, especially when combined with a Pap test, and can help detect precursor cancers at an early stage.
If the test is positive, there is no cause for concern, as infections do not always lead to cancer. Regular examinations are recommended to detect tissue changes at an early stage. Conversely, a negative test result does not indicate whether there was a past infection that the body successfully fought off.
In men, there is no preventive examination in which the examination is carried out regularly. If an underlying cancer exists, examination of the tumor can determine whether HPV infection is at the root of 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 papilloma virus
In most cases, the disease does not require treatment, because it passes by itself and after that the viruses are no longer detected. But if this is not the case, the infection can last longer and persist for months or years.
To date, there are no methods of systemic impact on this virus that could 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, the pathogens survive and can cause symptoms of the disease again and again.
- Plantar and genital warts can be treated with topical medications formulated with salicylic acid.
- 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 much more difficult to treat. For cervical cancer, it is often recommended to remove the uterus, the upper part of the vagina and the ovaries, respectively. This can be supplemented with radiation therapy to eliminate the possibility of recurrence. 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, but only solves a cosmetic problem, since after removal the virus can remain in the surrounding tissues and condylomas can reappear.
Prevention of infection
There are two vaccinations: the bivalent vaccine against HPV 16 and 18 and the quadrivalent vaccine against HPV 6, 11, 16 and 18. Vaccination is recommended for all young girls aged 14 years and older.
Vaccination does not protect against all types of HPV. Therefore, all women aged 25 to 65, even vaccinated, are advised to undergo regular pap smears.
Timely detection and complete removal of condylomas reduces the risk of disease. The effectiveness of using condoms to protect against 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 plantar warts appear and methods of treatment
Warts are skin lesions that appear in the form of special round formations protruding above the surface. They occur due to specific viruses.
These formations often cause physical discomfort due to their location. Even after treatment, they tend to recur.
Types and causes
There are many varieties of warts, they are classified according to a number of characteristics:
- just. They appear on the exposed parts of the body, hands, feet, 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 as in "families".
- Plantar. Their localization is exclusively on the legs. Causes discomfort when walking.
The main cause is infection with the human papilloma virus, which affects the mucous membranes and skin.
Human papilloma virus
It is one of the most common viruses on Earth. Infection can occur in several ways:
- contact-bit (by touch);
- sexual (genital, anal, oral-genital);
- at birth from mother to child.
The period of development of the disease varies from several weeks to tens of years, this is explained by the fact that the virus may not manifest itself for a long time, but as soon as the immunity becomes a little weaker, growths on the skin and/or mucous membranes immediately appear. The main danger of this disease is that some types of HPV are very 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 an examination by a doctor, and not to self-medicate.
Symptoms and types of warts on legs
A plantar wart appears as a callus-like thickening with a layer of stratum corneum on the skin. It interferes with walking and causes pain. The passive state is characterized by slow reproduction, lack of stratum corneum of the epithelium, so this state is not manifested externally.
The active state is characterized by the fact that the virus develops rapidly and, rising to the upper layers of the epidermis, manifests itself in numerous symptoms. Plantar wart is also called spike wart, chicken wart. The virus enters upon contact with the skin through cuts and scrapes in the outer layer of the skin:
- 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 fused papillae of various sizes with a pink tint. Extra capillary vessels form there, which cause bleeding if you catch a wart.
Removal of plantar warts
It is worth treating a plantar wart if:
- There are painful sensations.
- The wart is bleeding.
- It had stains on it.
- The wart rapidly increases in size.
There are many methods of treatment. 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.
The usual and aggressive method of exposure is used. In the aggressive method, the nitrogen is applied for a few seconds longer, but this method is more painful. It is important to note that if the wart appears and exists for more than six months, then the effectiveness of cryodestruction is significantly reduced and, accordingly, the meaning of such an operation also disappears.
After removing a plantar wart with liquid nitrogen, you should follow some recommendations:
- the blister left at the site of the wart cannot be opened;
- to avoid mechanical damage, use a sterile bandage, not a plaster;
- Treat the affected area with salicylic alcohol 2% twice a day;
- try to prevent water from entering the affected area.
Another method is laser coagulation. This is one of the most common methods of wart removal. Most laser systems are equipped with a special cooling system. Thus, the procedure takes place with minimal discomfort and does not allow inflammation, since the laser has antiseptic properties. Moreover, it is a non-contact method.
There are several ways:
- Carbon dioxide (CO2) laser. Treatment in this case is carried out using infrared light. The method is 70% effective, but the disadvantage is that healthy tissue can also be damaged.
- Erbium laser. This treatment method uses a shorter wavelength, which reduces the likelihood of scarring after surgery. Efficiency is typically 75%.
- Pulsed dye laser. With this method of exposure, the primary destruction of the enlarged capillaries in the wart and stimulation of the immune system, which contributes to effective healing. The effectiveness of the treatment is about 95%.
After laser treatment, a crust forms on the affected area, which 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 water penetration.
The next way to remove warts is electrocoagulation. In this case, a high-frequency current is applied to the wart. The treatment is performed under local anesthesia. Exposing a wart to high temperatures causes the cells affected by the papilloma virus to evaporate. Another advantage of this method is that cauterization of blood vessels prevents bleeding. After the operation, a crust forms on the affected area of the skin, which disappears within 7 to 10 days.
A plantar wart can be treated with direct surgery. In this case, the excision is performed under local anesthesia, after which sutures are applied. After the operation, the doctor will prescribe certain recommendations. Therefore, 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 during the first 7-10 days.
For each type of operation there are certain contraindications. Thus, it will be impossible to perform the operation if the following occurs:
- pregnancy;
- diabetes;
- malignant tumors in the body;
- infection and inflammation around the wart;
- exacerbation of herpes;
- elevated temperature.
If your blood pressure is high, the procedure should also be postponed.
Treatment of warts without surgery
People often wonder how to remove a plantar wart without surgery. To do this, you can use pharmaceutical ointments and solutions.
In general, these ointments have the following effects:
- anti-inflammatory;
- antiseptic;
- immunomodulatory;
- anti-virus;
- antifungal.
In addition, it may contain vitamin E, which also has a positive effect on treatment, since vitamins generally strengthen the body and reduce the risk of relapse.
It is important that these products are used for single and shallow plantar warts. In addition, if any side effects occur, it is necessary to wash off the medicine abundantly with warm water and immediately seek help from a doctor.
So, it is possible to treat warts, there are many ways to do this, but you should not do this without first consulting a doctor, so as not to harm your health. In addition, it is strictly forbidden to self-medicate if the attending physician prescribes contraindications.
Treatment of papillomas on the body
Hardware methods
Modern hardware methods for the treatment of papillomas allow you to get rid of them and prevent the development of a recurrence of the disease. The most commonly used methods are:
- Cryodestruction is the destruction of growths by exposing them to low temperatures.
- Electrocoagulation is cauterization of formations with electric current, the power and frequency of which are selected depending on the size, type and density of the papilloma.
- Laser removal. The type of shot is clear from the name. The procedure takes no more than 15 minutes and helps to get rid of unpleasant formations forever.
Medication treatment
Among the medicines used are jaggery, castor oil, lapis pencil, Sani Skin preparations and Dermavit.
They demonstrate varying effectiveness and do not prevent relapse of the disease. The main disadvantage of drug therapy for papillomas is the frequent development of allergic reactions.
Prevention of papillomas
To avoid the appearance of growths and to avoid infection with the human papillomavirus, you should:
- Use barrier contraception during intercourse.
- Follow the rules of personal hygiene and use only individual towels, soap and toothbrush.
- When visiting public baths, do not neglect to wear rubber shoes.
You should also normalize your daily life, eat a balanced diet, give up bad habits and avoid stressful situations. These factors are not the cause of the disease, but they can provoke its development if the virus is already present in the body.