engleski

WHAT NOT TO DO IN HUMAN PAPILLOMAVIRUS GENITAL INFECTIONS?

Anogenital warts (condylomata acuminata) are the most common HPV lesions presented in men, however, during the last decade the other HPV- associated exaggerated lesions such as condylomata plana, penile, scrotal, and anal intraepithelial neoplasias (so, not only cervical!), as well as the penile, oropharyngeal and tonsillar cancer have been studied a little bit more extensively. Some examples of “not to do” situations are listed. If, for example, a pregnant woman turns out to be positive for the high-risk types of HPV associated with cervical cancer, she should be monitored during the pregnancy to watch for cervical tissue changes. If possible, treatment should be postponed, because it may lead to premature labour. Genital warts can be removed surgically, as well as with cryotherapy or curettage. However, chemical cytotoxic drugs for genital warts removal should not be used during pregnancy! More than 35 types of HPV infect the genital tract ; types 16 and 18 inducing about 70% of high-grade intraepithelial genital neoplasias, 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. 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 (thus, not only female patients) 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. 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 dermato-venereological issue.

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

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