Chokoeva Anastasiya Atanasova, Wollina Uwe, Lotti Torello, Maximov Georgi Konstantinov, Lozev Ilia, Tchernev Georgi
"Onkoderma"- Policlinic for Dermatology and Dermatologic Surgery, Sofia, Bulgaria.
Städtisches Klinikum Dresden - Department of Dermatology and Allergology, Dresden, Sachsen, Germany.
Open Access Maced J Med Sci. 2018 Jan 13;6(1):110-111. doi: 10.3889/oamjms.2018.007. eCollection 2018 Jan 25.
Condyloma acuminata represents an epidermal manifestation, associated with the epidermotropic human papillomavirus (HPV). They have been reported as the most common sexually transmitted disease, with prevalence exceeding 50%, increased up to 4 times, within the last two decades, as the most common side of affection are the penis, vulva, vagina, cervix, perineum, and perianal area, with increased prevalence in young, sexually active individuals. Increased attention should be focused on lesions, caused by types, with moderate (33, 35, 39, 40, 43, 45, 51-56, 58) or high risk potential (types 16, 18) for malignant transformation, leading to further development of cancers of anus, vagina, vulva and penis, as well as cancers of the head and neck. A provident of coexistence of many of these types in the same patient could be seen in approximately 10-15% of patients, as the lack of adequate information on the oncogenic potential of many other types complicated the treatment and the further outcome. Although the variety of treatment options, genital condylomata acuminata still show high recurrent rate to destructive topical regiments, because of the activation of the viruses at some point, which emphasise the importance of virus- eradication, instead only of the topical destruction of the lesions. Despite decreasing the recurrent rate, the most important goal of immunisation is the reduction of the incidence of HPV-associated squamous cell carcinomas using either the quadrivalent (Silgard/Gardasil) or the bivalent (Cervarix) HPV (human papillomavirus) vaccine. We present a patient with periurethral condylomata acuminate, who refused performing of a biopsy for determining the virus type, as we want to emphasize the importance of the virus - treatment in all cases of genital warts, instead only of topical destruction of the lesions, not only because of the recurrence incidence rate, but also because of the well - known oncogenic potential of some HPV - types, as well as the unknown potential of various underestimated types, in contrast.
尖锐湿疣是一种表皮表现,与嗜表皮人乳头瘤病毒(HPV)有关。据报道,它是最常见的性传播疾病,患病率超过50%,在过去二十年中增加了四倍,最常受累的部位是阴茎、外阴、阴道、宫颈、会阴和肛周区域,在年轻的性活跃个体中患病率更高。应更多关注由具有中度(33、35、39、40、43、45、51 - 56、58型)或高风险恶性转化潜能(16、18型)的HPV类型引起的病变,这些病变会导致肛门、阴道、外阴和阴茎癌以及头颈癌的进一步发展。在大约10% - 15%的患者中可以看到同一患者体内存在多种此类HPV类型,因为许多其他类型的致癌潜能缺乏足够信息,这使得治疗和后续结果变得复杂。尽管有多种治疗选择,但由于病毒在某个时间点被激活,生殖器尖锐湿疣对破坏性局部治疗方案仍显示出高复发率,这强调了根除病毒的重要性,而不仅仅是局部破坏病变。尽管降低了复发率,但免疫接种的最重要目标是使用四价(希瑞适/加德西)或二价(卉妍康)HPV(人乳头瘤病毒)疫苗降低HPV相关鳞状细胞癌的发病率。我们报告了一名患有尿道周围尖锐湿疣的患者,该患者拒绝进行活检以确定病毒类型,我们想强调在所有生殖器疣病例中病毒治疗的重要性,而不仅仅是局部破坏病变,这不仅是因为复发率,还因为一些HPV类型众所周知的致癌潜能以及各种被低估类型的未知潜能。