engleski

WHAT SHOULD THE DERMATOVENEREOLOGIST KNOW ABOUT HPV?

Anogenital warts (condylomata acuminata) are the most common HPV lesions presented in men, however, during the last decade the other HPV-associated lesions such as condylomata plana, penile, scrotal, and anal intraepithelial neoplasias, as well as the penile, urine bladder and prostate cancer have been studied a little bit more extensively. However, consistent studies are still sparse for male population. More than 35 types of HPV infect the genital tract ; types 16 and 18 inducing about 70% of high-grade intraepithelial genital neoplasias, such as penile, anal, scrotal, vulvar, vaginal etc. (thus not only cervical), and HPV 6 and 11 causing 90% of anogenital warts. However, the "banality" of anogenital warts should not be underestimated providing that the high risk HPV DNA 16 and 18 can be isolated (PCR) from "benign" HPV-associated genital lesions (anogenital warts) in 10-20% of patients, i.e. more than it is usually expected. On the other hand, the presence and the recalcitrant course of HPV DNA 6 and 11 associated diseases represent a significant physical and psychological problem for both men and women. A prophylactic vaccine that targets these types should thus substantially reduce the burden of HPv-associated clinical diseases. Ultimately, within the spectrum of therapeutic options for condylomata, no method is really superior to others ; recurrences occurred in 30-70% of cases. We definitely need the HPV vaccination programme to get rid of one of the oldest and up to now unsolved problems of mankind. Since HPV is transmitted by sexual intercourse, managing both partners is necessary in order to eliminate the virus in the population. Approaches to this include prophylactic vaccines such as quadrivalent HPV vaccine for both men and women. This should be the only way to significantly decrease the numbers of infected persons. Besides, a proper dermatological training is required as the clinical criterion is still very important and the HPV induced lesions get quite often misdiagnosed unless managed by the skilled professional. It can be thus concluded that the HPV-genital infections represent a significant dermatovenereological issue, and the dermatovenereologists should definitely be the part of the HPV vaccine programme team

Anogenital warts (condylomata acuminata); HPV Lesions; prophylactic vaccine

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