condyloma acuminatum in women
Introduction
Introduction to female genital warts Female genital warts are epithelial proliferative lesions caused by human papillomavirus infection and are one of the important sexually transmitted diseases. The warm and moist vulvar skin mucosa facilitates its growth and reproduction, forming a vulva or vaginal condyloma acuminata. However, not all genital warts are all genital warts. The average incubation period of female genital warts is 2 to 3 months. There is no self-limiting disease development. The symptoms are local itching and pain, and a few patients are asymptomatic. Growth site: vulva, vagina, cervix, perianal, common two sites occur at the same time, local manifestations of light red or gray small papules, ridge-like protrusions, often merged to form cauliflower-like mites, history of sexual disorder, with 5% After the acetic acid was applied, the lesion became white. Pseudocondyloma incubation period of 3 days to 3 weeks, there is self-limiting, generally asymptomatic, and some local itching, more common bilateral mascara symmetry distribution, rare two sites at the same time, the lesion is a fish-like or pearl-like small pimples Some are polypoid-like, fluff-like, not fused, history of asexual disorder, 5% acetic acid after coating does not change white. The cause is not known, and some people think it is related to multiple hormones, fungal infections or other chronic stimuli. basic knowledge The proportion of illness: 0.003% Susceptible people: women Mode of transmission: sexual transmission Complications: cervical invasive cancer
Cause
Female genital warts
Bad sexual behavior (60%):
Most sexually transmitted diseases are caused by bad sexual behavior. If a woman has multiple sexual partners who are more likely to have genital warts, a survey has shown that people with multiple sexual partners are more likely to have genital warts than single partners. Women who are sexually young are also very likely to have genital warts. Women have sex before the age of 18, and the incidence of genital warts and recurrence rates are much higher for older women. Therefore, in order to ensure health, we must strictly abide by bad sexual behavior. If we are too young, we must prohibit sexual behavior. If we are young, we will have genital warts, which will have a serious impact on future fertility.
Low immune function (10%):
Patients with low immune function are easily infected by diseases such as lupus, malignant tumors, kidney transplantation, glucocorticoids, the incidence of condyloma acuminata and recurrence, and the carcass is large and difficult to treat. For patients with low immune function, we must take care to protect our body and take various preventive measures in life so as to prevent the occurrence of genital warts.
Other factors (5%):
A other sexually transmitted disease is also very likely to cause genital warts in women. Like gonorrhea, trichomoniasis, melanin, fungal infections, etc., these diseases can destroy the mucosal protective barrier, reduce the ability to resist infections of these diseases, and make the local environment of the genitals moist, so that the virus can easily breed and breed. Causes women to develop genital warts.
Prevention
Female genital warts prevention
1. Please remember to clean the toilet after going to the toilet. Because the anus may bring a lot of bacteria, please do not rub the anus to the genitals after going to the toilet to reduce the chance of infection. Do not rinse the vagina, because the vagina has a self-cleaning function, if it is intentionally flushed, it is not good.
2, the washing of the underwear is best to wash with a mild soap, do not use a powerful detergent or washing machine. Wear cotton underwear, try not to wear nylon, synthetic fiber materials, in order to maintain ventilation and ventilation.
3, resolutely put an end to sexual disorder: 60% of patients with genital warts are infected through sexual contact, which not only brings physical pain, but also causes family disharmony and burdens with mental stress. Therefore, improving sexual ethics and not taking extramarital sex are important aspects to prevent the occurrence of genital warts.
4, to prevent contact with infection: do not use other people's underwear, swimwear and bath tub; do not wash the pond in the public bath, promote shower, do not sit directly in the bath seat after bathing; use the toilet in public toilets as much as possible; go to the toilet Wash your hands with soap before; do not swim in a pool with high density and poor disinfection.
Complication
Female genital warts complications Complications Cervical invasive carcinoma
1. Condyloma acuminata can be complicated by malignant transformation. Epidemiological data suggest that there is a close relationship between condyloma acuminata and genital cancer. It has been reported that 5% to 10% of vulva, cervix, and perianal genital warts may develop cancer and develop into carcinoma in situ and invasive carcinoma after a long period of time. 5% of female vulvar cancers occur on the basis of the original condyloma acuminata. Many experimental studies have also shown a causal relationship between HPV, condyloma acuminata and genital cancer.
2. This disease is often complicated with other STD. About 1/3 of patients with condyloma acuminata suffer from gonorrhea, syphilis, chlamydia infection, trichomoniasis, etc. It should be checked and detected and treated in time.
Symptom
Female genital warts symptoms Common symptoms vulvar squamous epithelial squamous hyperplasia vulvar ulcer vulva burning irritating ulcer appearance is cauliflower vulvar damage
Female patients are very devastated by genital warts. When the female genital warts occur in the vulva, the most typical symptom is that there are very few reddish and very small pimples in the early stage of the disease, and then the disease will develop. Further changes become larger and larger, and the pimples will blend or overlap, and the surface looks very uneven, like a carcass. Because some parts are very hot and have chronic stimuli, the corpus callosum will grow rapidly and eventually become a different shape, such as papillary, cauliflower, cockscomb or scorpion. These corpuscles are very natureful. Soft, it will be very easy to bleed.
In some patients with genital warts, the secretions produced during the onset of the disease are white, filthy or red, infiltrating the surface of the corpus callosum, causing great inconvenience to the lives of female patients. The roots of the carcass are very narrow, and there are pedicles. The surface is also very moist. It often has the phenomenon of exudation, erosion, and skin lesions. At the same time, there is a very purulent secretion in the gap between the cracks. It is very prone to bacterial infections and has a very strong stench. The symptom that women themselves feel is that the affected area is very itchy, burning or pressureful.
Examine
Female genital warts check
First, acetic acid white test
Exfoliate the carcass with 3-5% acetic acid for 2-5 minutes, the lesion site becomes white and slightly elevated, and the anal lesion may take 15 minutes. The principle of this test is that the protein and acid coagulation become white. The keratin produced by HPV-infected cells is different from that of normal uninfected epithelial cells. Only the former can be decolorized by acetic acid. The sensitivity of the acetic acid white test for detecting HPV is high. It is better than the conventional test to observe histological changes. Occasionally, false positives, false positive whitening signs appear to be unclear and irregular in the case of epithelial thickening or traumatic scuffing. The US CDC suggests that the acetic acid white test is not a specific test, and false positives are more common.
Second immunohistological examination
A commonly used peroxidase antiperoxidase method (ie, PAP) displays viral proteins in the sputum to demonstrate that there is a viral antigen in the sputum lesion. A weak red-light positive reaction may occur in superficial epithelial cells of condyloma acuminata when HPV protein is positive.
Three tissue chemical examination
A small amount of diseased tissue was taken to make a smear and stained with an antibody specific for human papillomavirus. If there is a viral antigen in the lesion, the antigen-antibody binds to the peroxidase anti-peroxidase (PAP) method and the core can be stained red. This method is specific and quicker for diagnosis.
Four pathological examination
Mainly for the hypertrophic keratinized layer of hypertrophy, papillary hyperplasia, epidermal stimuli thickening, its degree of hyperplasia can be pseudo-epitheliomatosis. The thorn cells and basal cells and a considerable number of nuclear divisions are quite cancerous. However, the cells are arranged in a regular manner, and the boundary between the proliferating epithelium and the dermis is clearly characterized by the formation of vacuoles in the upper cells of the granule layer and the thorn layer. Such vacuolar cells are larger than normal, and there is a large, round, deep basophilic nucleus in the center of the cytoplasm. Often dermal edema telangiectasia and a denser chronic inflammatory infiltration around. Bushke-loewenstein huge condyloma acuminata, the epidermis is extremely downward growth instead of the underlying tissue, easy to mix with squamous cells, so the need for multiple biopsy, if there is a tendency to slowly develop, is a process of low malignant transformation, That is, sickle cancer.
Diagnosis
Female genital warts diagnosis and identification
It is especially important to diagnose 5 points below genital warts:
1, the papillary structure is a basic lesion, if the lack of nipple structure is classified as non-specific female genital inflammation.
2, poor keratinization is obvious.
3. The spine cell proliferation is obvious.
4, basal cell proliferation is obvious.
5. Diagnostic hollowing out cells.
