Diagnosis - HPV

Papilloma is a benign neoplasm of the skin, the distinguishing feature of which is a connective tissue-based papilla covered by epithelium at the top. Papillomas appear in humans in various areas of the body (on the skin, mucous membranes, internal organs and other locations) and in most animals.

Papillomas develop from the transitional or squamous epithelium to the form of dense, soft formations in the so-called peduncle. The size of these formations usually varies from 1 to 2 centimeters in diameter, and the outer surface of them has a white or dirty brown hue. Sometimes papillomas grow in different directions and become like a rooster's cauliflower or comb.

Papillomas are removed for a cosmetic effect if they occur in visible areas of the body - on the neck, arms, face, however, if they occur in many areas of the mucous membrane, for example, in the larynx, patency disorders can be caused thatthreaten the patient's life. In the case of the larynx, the papilloma can block the airways, causing voice problems or the inability to breathe normally, in the case of the bladder the papillomas cause hematuria. If several papillomas are formed in the body, this indicates the onset of papillomatosis.

Etiology of papillomas

For the most part, papillomas are caused by a viral infection - the human papillomavirus (HPV), although papillomas can sometimes occur congenitally or as complications of inflammatory diseases.

When HPV enters the human body, its activity usually begins to manifest after a long time. Often, some provocative factors contribute to the activation of the papillomavirus, from which soft neoplasms appear on the skin or mucous membranes. Experts include stress, decreased immunity, weakened body due to treatment, deficiency of vitamins in the body, trauma to the skin as the main factors that cause papillomas.

Basically, people are infected with the papillomavirus sexually, however, it is also possible cases of domestic infection with very low immunity or in the presence of damaged areas of the body's skin that may come into contact with an HPV carrier. The appearance of papillomas indicates the activation of the existing virus, which is equally possible for women and men. A baby can be infected with this virus by passing through the birth canal of an infected mother.

Exophytic condylomata

Classification of HPV manifestations

The human papillomavirus that infects mucous membranes and skin can be classified into the following forms:

  • clinical form that can be detected in the routine examination: genital, papular and papillary warts, exophytic warts, in addition to cervicitis and cervical erosion in women;
  • subclinical form, in which the formations have no symptoms, are not visible and can only be detected during endoscopy: inverted formations (growing into the mucous membranes), flat warts, as well as warts in the cervical canal;
  • latent form, characterized by the absence of clinic and detected exclusively by the results of the analyzes;
  • female form or cervical form, expressed by cervical cancer or multi-stage dysplasia.

When women are infected with highly oncogenic HPV as a result of sexual contact, the likelihood of malignant neoplasms in the cervical canal increases dramatically. When infected with other types of the virus, the likelihood of oncology is not as high, however, a cancerous tumor can occur in the rectum or oral cavity. In men, the probability of cancer due to HPV exists in the anus, penis and rectum.

Types and forms of papillomas

It is very important to correctly identify the papillomas that appear on the body. Their types depend directly on the resulting virus strain, which, entering the human body, contributes to the process of excessive cell division of the skin, resulting in papillomas.

HPV strains can be oncogenic and non-oncogenic. There are many other non-oncogenic varieties and, as a rule, they bring nothing to the patient, except external aesthetic discomfort.

Such a manifestation can be easily removed, thus solving the problem. However, if neoplasms arise in the area of ​​mucous membranes, this indicates serious pathological processes. Such displacement means that a person has been infected with an oncogenic HPV strain, so complex antiviral therapy is sorely needed. To distinguish between different types of papillomas, just compare them and identify the distinguishing characteristics of one or another subspecies.

Plantar wart

Simple warts

Simple papillomas or warts are the most common type of papillomavirus caused by several strains at once. These HPV strains are transmitted not only sexually, but also by contact and in everyday life, which leads to statistics that indicate that 30% of the world's population has encountered this type of HPV at least once in their lives.

Simple papillomas or common warts (common) are more often located in other places on the upper extremities, namely on the hands, but sometimes they can also occur on the body, soles and feet, palms, fingers. Its peculiarity is that such warts appear in places with damaged skin due to decreased local immunity. These papillomas occur in the area of ​​the sole of the foot or the palms of the hands due to contact with low quality household chemicals, profuse sweating, various damages to the skin, dermatitis.

The wart vulgaris externally looks like papillary neoplasms of skin with a few millimeters in diameter at the beginning of the disease. In this case, the wart's head has a smooth and homogeneous texture and rises above the skin's surface. It is poorly pigmented and its root penetrates deeply into the skin, where it receives nourishment from the vessels. As a result of this nutrition, warts gradually grow, while not only their size changes, but also the degree of pigmentation. In addition, the hair usually grows in the center of these papillomas, which is a variant of the norm and does not indicate a malignancy.

Flat papillomas

Skin growths like these look like small, flat, yellowish plaques that rise just above the skin's surface. Its structure is dense, with a deep subcutaneous root, evidenced by frequent pain when pressing the wart or when it is damaged on a daily basis. The location of such papillomas is most often on the face and hands. Sometimes they can occur in the anus or the labia majora in women and the scrotum in men. Due to the active blood supply, they have an active upward trend.

The main characteristic of flat papillomas is the difficulty of treatment. After surgical treatment of these neoplasms, the scars and scars usually remain in place.

Genital warts

Genital warts occur in the groin area or on mucous membranes. Externally, they are thin papillary neoplasms of 2 to 3 millimeters in diameter. These condylomas grow quickly, forming a large skin growth from a small single papilla, resembling a cauliflower or a cock's crest.

The main danger of genital warts is the high risk of infection, inflammation of neoplasms in the vagina or small lips in women. They can be easily injured, after which the infection penetrates the body at high speed. In addition, a major problem associated with genital warts is the high risk of recurrence, which is not reduced even with the use of antiviral treatment and the removal of neoplasms. Several strains of the virus can cause genital warts, some of which can be dangerous for women in terms of the malignancy.

Examination of a patient with papillomas

Filiform papillomas

Threaded papillomas with a thin stem, the upper part crowned by the head of the neoplasm. They are very difficult to confuse with other species due to their special aspect, therefore, looking at the photo of the filamentous papillomas, they can be differentiated from other varieties.

These neoplasms appear more frequently after the age of 45 in areas where thin skin prevails - on the chest, armpits, on the neck. The increase in the size of these neoplasms is their additional stretching. The head of filamentous papillomas is usually yellow or pink, the pigmentation is not expressed, in most cases very weak.

Internal moles

Any neoplasm on the surface of a person's internal organs can be classified as a subgroup of internal spots. These are intragastric condyloma, papillomas in the rectum, neoplasms in the throat and mouth, neoplasms in the bladder walls. A distinguishing feature of these papillomas is the impossibility of their recognition without carrying out appropriate medical procedures and diagnoses. However, the disease can be suspected by special symptoms. The danger of such neoplasms is identified in each case.

If there are papillomas in the bladder, bleeding or cancer may occur over time.

If the papilloma is located in the larynx, it helps to block breathing and interferes with the person's speech function.

Lewandowski-Lutz Papillomas

Verrucous epidermodysplasia or Lewandowski-Lutz papillomas is a very rare condition that mainly affects only children or adolescents. It turns out that this disease can be inherited and spread in a family.

The clinical picture of the disease manifests itself in the form of numerous warts with reddish-brown spots on the feet and hands. A characteristic of the pathology is the fact that, when papillomas are located in areas of the body exposed to ultraviolet radiation, in one third of the cases they are reborn in malignant neoplasms and grow in areas of neighboring tissues.

Decreased immunity - a factor that causes papillomas

Papillomas sites

Filamentous, common or pointed papillomas, as well as condyloma, are the most common in medical practice. The location of the filamentous warts is the face, the common ones are located more frequently in the feet or hands and the condyloma are exclusively in the mucous membranes (head of the penis and urethra in men, in the region of the small lips and vagina in women), but it turns out that any of these warts can occur in an unusual place for them.

It is not difficult to remove these papillomas in modern conditions, but the danger is the fact that, with decreased immunity, new papillomas may reappear, which will lead to more serious health consequences, for example, the subsequent occurrenceof genital warts is fraught with the development of cervical cancer in women uterus. Plantar warts are more common on the rough soles of the feet and feet. Occasionally, a thorn may develop in the thumb after severe damage to the skin of the area.

In general, papillomatosis is a generalized form of pathology, in which neoplasms are formed throughout the human body. These growths have a characteristic aspect, therefore, having seen the manifestations of the disease once, it can no longer be confused with any other disease.

HPV symptoms

The most common symptom of papillomavirus in the human body is the appearance of papillomas on the skin.

The rest of the symptoms depend directly on the location and type of disease. Depending on the signs above, the symptoms of HPV may be as follows:

  1. Genital warts occur on the mucous membranes of Organs genitals, mouth, larynx, rectum and on the inner surface of the stomach. Symptoms of the onset of pathology in the genital area are itching and an unpleasant odor. If such symptoms start to bother you, in no case should they be ignored, as the cause of their occurrence can often be of an oncogenic nature.
  2. Intraductal papillomas in the area of ​​the ducts of the mammary glands, whose signs are redness in the area of ​​the nipples, mild itching and burning. In addition, if you press on the nipple with this papilloma, a green ichor or discharge starts to leak from it. The danger of intraductal papilloma is its gradual and possible degeneration in breast cancer.
  3. Plantar warts are expressed as active calluses in the soles of the feet, which, when walking or pressing on them, acutely cause pain.
  4. Papillomas in the larynx area are not initially expressed in any specific symptoms, but gradually this pathology leads to a change in the person's voice, a feeling of coma in the throat and impaired respiratory functions. In addition, the patient begins to experience difficulty in swallowing.
  5. Flat warts in adolescents occur more frequently on the outer area of ​​the hands and on the lower part of the face. The symptoms are very cloudy and are most often expressed in mild and rare itching of neoplasms.
Human papilloma virus


In the presence of HPV in the human body, it is more often possible to conclude that immunity is reduced. Once in the body, viruses begin the process of infection of the basal epithelial layer, making the main bias of affecting the transition area from the stratified squamous to the cylindrical epithelium. In infected cells, there can be 2 forms of viruses - episomal (outside the cell chromosomes) with a benign and introsomal nature (integrated in the cell genomes) with a parasitic malignant nature.

The papillomavirus incubation period can vary from the moment the virus enters the body until the first manifestations of the disease in a period of 14 days to a few years. The nature of human papillomavirus infection is usually latent, that is, hidden. At the same time, several varieties of pathologies can settle in the human body at the same time and, under the influence of certain factors, each of them can, at the same time, start to manifest through active reproduction. In this case, a stage of the disease appears, in which the clinical manifestations begin to be identified.

Often (up to 90% of all cases of HPV infection), the human body will heal itself from this pathology for 6-12 months, but in 10% of the remaining cases the disease can become chronic with a long course, recurrences and the possibility of malignancy in the process.

Diagnosis of diseases

Ultrasound for papillomas

In the diagnosis of papillomas, ultrasound is not used as the main research method, but as a complementary method, confirming the correction of the alleged diagnosis. Basically, ultrasound is used to diagnose papillomas in internal organs when it comes to their malignant transformation.

Ultrasonography is used among instrumental verification techniques for the diagnosis of intraductal papilloma.

Ultrasonography in this case does not allow the specialist to examine the ducts of the mammary glands, however, it helps to differentiate the intraductal papilloma from the suspicion of breast cancer, allowing the exclusion of galactorrhea in prolactinoma. In addition, ultrasound can help detect the occurrence of neoplasms with bladder papilloma. However, ultrasound in this case is effective only if neoplasms exceed 1 cm in diameter.

PCR analysis

Diagnosis of PCR when making a diagnosis

The diagnosis of the disease in question is made by doctors, dermatologist and venereologist. Since the number of virus types is diverse, it is important to determine precisely which type the patient is infected with and whether this strain has an oncogenic character. Visually, it is possible to make an accurate diagnosis only for classic genital warts, so if HPV infection is suspected, specialists always use PCR scraping.

The polymerase chain reaction (PCR) invites researchers not only to determine the presence of HPV in the body, but also to demonstrate its type, oncogenicity and the number of viruses at the time of diagnosis. This is very important in terms of diagnosis, because if there is information about the percentage of the virus in the body, it is possible to determine the approximate date of the infection and to establish the patient's contacts for carrying out the etiotropic therapy.

Based on the results of CRP diagnoses, it is possible to determine the chronic course of the infection or its unique outbreak due to decreased immunity. This information gives the specialist the opportunity to prescribe appropriate therapy for a specific case. Usually, the diagnosis of CRP is performed in the form of screening. If a virus is confirmed in the body, the patient continues to be examined by other techniques.

HPV biopsy

Biopsy in medicine refers to the procedure for collecting samples of human tissue for subsequent examination by staining with special dyes. Biopsy is very common in cancer, as well as in suspected HPV. On the eve of papillomavirus treatment, doctors must rule out the oncological nature of neoplasms.

Biopsy is a highly accurate diagnostic technique that, if HPV is suspected, can be expressed in cytological or histological studies.

The cytological exam is a study of the cells of the body under a microscope, designed to demonstrate to specialists the changes that a viral infection has caused in these cells. For the prevention and early detection of cervical cancer, cells from this organ are removed for cytological examination in a woman. If oncogenic HPV types are detected in women, even in the absence of external signs and manifestations, cytological studies are attributed to them annually, allowing them to observe the signs of cervical dysplasia in a timely manner. The fact is that dysplasia of this organ is completely curable, and if you don't start the development of the process, cervical cancer in the body will not develop, even with a type of oncogenic virus.

In order to accurately diagnose HPV, a histological study is performed, for which a superficial scraping of the patient's cells is removed for analysis, but a piece of tissue, which allows the correct location of the cell layers, characteristicstissue and identify oncological characteristics. In the histological examination with the aid of solutions, the tissue sample removed is dehydrated and embedded in paraffin, after which microtome cuts are made, which allow obtaining layers with a thickness of 0. 1 mm. The removed layers are stained with special dyes to reveal pathological cells during microscopic examination and determine their nature.

Examination by dermatologist

Treatment of papillomatosis

Papillomavirus treatment is always carried out according to an individual schedule. If a virus is detected during diagnosis, but there are still no manifestations, the patient is prescribed etiotropic cytostatic therapy, which effectively "soothes" the virus for several years.

If a person has HPV, they should undergo a diagnosis of CRP regularly to identify the early signs of disease development. In addition, the carrier of this virus is required to use barrier contraceptives in order not to infect sexual partners.

When detecting papillomaviruses, the use of antiviral agents in the treatment is mandatory. In general, immunomodulators and vitamin preparations are indicated for absolutely all patients with HPV.

When papillomas appear on the mucous membranes or on the skin, depending on the location and symptoms, cryodestruction, electrocoagulation and laser tumor removal are used. Sometimes, papillomas are also removed with a more modern technique - using radio waves. In case of signs of malignancy of the papilloma, it is removed surgically along with the healthy tissues surrounding the tumor. It is also important to know that the removal of the papilloma does not lead to a complete cure, as the virus remains in the body and can reappear.

There are no drugs for the complete elimination of this virus from the body in modern medicine, therefore, when this diagnosis is detected, even in the absence of manifestations, the person must undergo regular tests to detect the development of the pathology.

Since the papillomavirus is most often transmitted sexually, it is worth choosing a barrier method of contraception and, if a woman is planning a pregnancy, it is important to perform diagnostic measures in a timely manner and to undergo therapy that reduces the likelihood of infectionof the child with this virus.

Disease prevention

It is possible to prevent the appearance of papillomas in the body by observing the basic rules of personal hygiene and timely disinfection of any wounds. It is essential to use a separate towel, comb, manicure devices, shoes for each member of the family on a daily basis, and intermittent sex should always be protected with condoms. It is also important, after intercourse, to always bathe and treat the contact areas of the skin and mucous membranes, as the virus takes some time to enter the human body.

In modern medicine, there is also a vaccine against human papillomavirus. It has been tested in 72 countries around the world and is effective against 16 and 18 HPV subtypes, which cause cervical cancer in 90% of all diagnosed cases. In addition, vaccination successfully fights viruses of subtypes 6 and 11, which cause the development of genital warts, which are difficult to treat. Due to the sexual route of infection with these viruses, it is recommended to vaccinate before a person begins sexual activity. Most of the time, experts recommend using the vaccine three times for girls aged 11 to 12 years. The World Health Organization recommends vaccinating boys as well, to prevent the possibility of HPV circulation.

Are papillomas dangerous?

Papillomavirus is a risk factor for the development of oncological pathologies. Most of the time, due to this virus, cervical cancer occurs, cancer of the external genitals (vulva, penis glans). However, HPV infection does not always lead to cancer. There are many subtypes of this virus with a low oncogenic index, for example, subtypes 6, 11, 42, 43, 44, which form condylomas, but there are also highly oncogenic subtypes - 16, 18, 31, 33, causing flat warts. From the moment the virus enters the body until the transformation of a neoplasm into a malignant one, it can take 10 to 20 years.

If there are large papillomas in the body, which can be easily damaged in everyday life, they must be removed.

If the papillomavirus detected in the body is not treated, the risk of getting other infections increases dramatically. And with the course of parallel infectious processes, papillomas begin to appear in other parts of the body, weakening the immune system. It turns out that it is a vicious circle. In addition, if some papillomas are not removed, they can degenerate into cancer neoplasms, which means that this disease must be treated very seriously and never let the course of the disease run its course.