Window - Symptoms and treatment

What is a wart?The causes of the occurrence, diagnosis and treatment methods will be analyzed in the article of a dermatologist with 37 -year experience.

Determination of the disease.Causes of the disease

Verals-This are not a light light neoplasms of the skin in the form of localized growth of the upper layer of the skin (epidermis) with papules (nodules) or plates.

The frequency of the appearance of warts in adults is 7 to 12%, in schoolchildren up to 10-20%.

Warts are very similar to other skin neoplasms.Usually a person cannot independently determine the disease independently, therefore, to make a diagnosis, it is necessary to contact a dermatologist.

The cause of the appearance of warts is the human papillomavirus.A variety of warts that can develop depends on the type of virus.Thus, each type of human papillom virus affects the fabric on the location which is most characteristic of it.

HPV type	Extremely location	Types of warts
1	Feet, knees, palms, Paintbrushes, fingers	Subharaariat and Palmar warts, Sometimes - simple warts
2, 4	Hands, fingers, knees, Less commonly - not	Simple warts, Sometimes - plantar, palmar and mosaic warts
3, 10	Shin, hands, face	Flat warts
7	Paintbrushes, fingers	Butcher warts
5, 8, 9, 12, 14, 15, 17, 19-24	Face, Hands, The front of the body	EpiderModysplasie Veruquette

Infection by a virus generally occurs in a contact path - with direct contact with infected and healthy skin (for example, with a handshake) or indirect (via current hands, toys, etc.).Consequently, it is possible to infected by the Papillomavis human virus in a wide variety of places - in public transport, at school, at work, houses, in places with high contact and a wet environment (swimming pools, saunas, gymnasiums).The small injuries of the epidermis by which viruses, as well as inflammation of the skin fall, contribute to infection.

In addition, the appearance of warts contributes to:

• immunodeficiency (including HIV infection);
• warm and humid environment;
• The need for professional contact with meat and fish ("butcher warts").

Certain types of human papillom virus are transmitted by parents.

But from toads and frogs, despite the horror stories that are so often afraid in childhood, you cannot infect yourself - this is one of the most popular myths on this disease that has no reason.

If similar symptoms are detected, consult a doctor.Not self -medicate - it's dangerous for your health!

Symptoms of warts

Depending on the type of wart, the symptoms will vary.

Ordinary wart:

• Dense round papule of a conventional color with a size of 1 to 10 mm and larger.
• The surface of the papule is covered with cracks, layers.
• If the father is on the finger, then the imprint disappears and distorts.The same goes for the drawing of the palm.
• Simple warts are located both simple and several rooms - they generally appear in places of larger injury (hands, fingers, knees).
• During examination with a dermatoscope, the doctor can see small brown points - thrombopable capillaries (obstructed).Patients often call these points of "roots".This is the main characteristic of the doctor: the dermatologist can distinguish a wart from other similar diseases (for example, contagious molluscs and keratomas).

Social wart (horn):

• The main symptom because of which the patient usually consults a doctor is pain during pressure and walking.
• These warts are generally located on the feet.
• When you contact a doctor, as a rule, an unequal keratinized plate of the usual color is visible, although in the first stage, you can see a still smooth papule.With keratinization, capillaries can only be seen if you remove the keratinized layer from the skin.
• The skin pattern is deformed.
• As a rule, plantar warts are single, but there are 2 to 6 pieces;
• Often, these warts are confused with a corn (in particular with the dry) - with this description of the problem the problem, the patients generally come upon reception.

Flat wart (young):

• In appearance, it is a round, clear and smooth papule of normal, pink or brownish color of 1 to 5 mm.
• Appears on the hands, the lower legs, very often on the face.
• There are always several of these warts - they are located in groups.

Epidermodisplazia de Verrucilia (senile wart):

• Large tour of many neoplasms merging normal, pink or brown.
• Most often appear on the face, hands, front face of the body.
• You can confuse with keratome, lichen and skin cancer.

Pathogenesis of warts

If the human papillomavirus enters the body in a latent state for a long time - a person generally does not even know their existence.When the factors seem favorable to the virus, it begins to "multiply" in the epithelium, leading to a change of tissues.

Unlike other viruses, the human papillomavirus does not destroy the cells of the epithelium - they die of themselves, of course - in the process of keratinization and exfoliation.

The propagation of infection is influenced by local factors and the state of the immune system.Thus, people with HIV infection or a transplanted kidney are more subject to the development of warts.In addition, these neoplasms are often difficult to treat.With normal immunity, the virus does not affect the deeper layers of the skin, so many people themselves have warts after a few months.

The main step in the appearance of warts is to accelerate the rate of division and cell growth with a virus.Such a rapid metabolism leads to the thickening of the skin layers.Since the fabrics grow in a certain small area, a tuber occurs, which is called wart.

Classification and stages of wart development

There is no universally recognized classification of warts.However, several frequently encountered varieties can be distinguished:

• Ordinary wart- The most common type (70% of warts are exactly them).Such neoplasms are not felt and only cause aesthetic discomfort to a person.
• Social wart- It appears on the painful feet, therefore requires treatment.The occurrence of such a wart is facilitated by skin injuries due to uncomfortable, cramped and rubbed shoes.
• Flat warts- More often, they appear in young people, adolescents.This is due to the unstable hormonal context of young people, which affects the whole body.Usually, flat warts are almost invisible.
• Senile warts- inherent in the elderly.Often appear on parts of the body, which is covered with clothes, but which can meet on the face and hands.If there is no discomfort, it is not worth dealing with such warts in the elderly can take place much more slowly, which is in young people, due to slow metabolism.

Other authors distinguish several others from these types of warts:

• Mosaic warts(HPV 2, 4) - Neoplasmes on palms and soles.They resemble foci of hyperkeratosis, that is to say thickening of the layer of stratum of the skin (generally in the front part of the foot), covered with deep cracks.
• Cystic warts(HPV 60) - A very rare type of neoplasm on the foot.It is a soft knot with cracks.When opening, the white yellow discharge appears, similar to cottage cheese.
• Film warts- The growths of the thin horn near the mouth, nose or eyes.
• "Butchers" warts(HPV 7) - Appears on the hands and fingers of people constantly in contact with meat and fish.They are presented in the form of hypertrophied neoplasms similar to cauliflower, but normal color.

In addition, the types of warts are distinguished according to their location.

Thus, neoplasms of Anglo -Verrus warts - in the shape of a tumor which appear on the genitals (especially in the places of skin transition to the mucosa) are often found.Usually they are caused by HPV 6 and 11.

Complications of the wart

The main reason why patients with warts go to the doctor is an aesthetic defect that can affect the quality of the patient's life, his self -confidence and develop many complexes.Complications also include cracking on the surface of the wart and the joy of infection, and with certain types of warts - pain during walking.

In malignant neoplasms, skin warts generally do not reborn, they are completely harmless, but in very rare cases, such a complication can still occur in people with oppressed immunity.

Other complications arise when you try to eliminate the neoplasms independently.In this regard, inflammation and aesthetic defects in the form of scars can occur, as well as the additional propagation of the virus on the skin, which is why a person can wake up with several news in the morning after the independent withdrawal of a wart.

Remember that under the cover of warts, a completely different disease can be hidden, which cannot be determined without consulting an experienced doctor.

Verrue diagnosis

As a rule, to make a diagnosis, there is enough inspection (clinical image) and collected history (medical history).

To confirm the diagnosis, the doctor can conduct a histological study - the study of neoplasm cells.

It is very important to conduct a differential diagnosis - to distinguish warts from other diseases.For example,Ordinary wartsIt is necessary to distinguish the following diseases:

• Mollusc contagioine- Almost often appears on the body and the genitals, less often on the hands and feet.It is a hemisphere with a pressure on the surface, when in a hurry on the sides, the whitish "porridge" stands out.
• Epidermal lag naevus- More often lonely, a person has birth.It rises above the surface of the skin, often covered with hair.
• Bazalioma- A tumor in the form of a roll of nodules, in the center is covered with a crust.Inherent in the elderly.

Warts supported by LandomaireIt is necessary to distinguish the following diseases:

• Keratoderm- large areas of keratinization and inflammation of the skin.There are no shabby capillaries.
• Ladamary-sifilides- multiple painless neoplasms, along the periphery, the skin is laying.The reaction to syphilis is positive.
• But- Usually painless, can only cause pain with vertical pressure.

The doctor must also differentiate the remaining types of warts from a number of diseases.In the event of suspicion of another pathology, it can prescribe additional diagnoses (for example, the identification of antibodies for viruses, CT or MRI).

Treatment of warts

The treatment of warts is carried out for aesthetic purposes and to improve the quality of life of the patient.It can only be prescribed by a doctor after examination and a diagnosis with precision.Independent attempts to get rid of the wart are unacceptable, as the patient without medical education and the necessary equipment are unable to determine the disease with precision, and complications after such "treatment" occur much more often than recovery.

There are several treatment methods for the treatment of warts.All are generally carried out under the supervision of a doctor, and some of them - only under the conditions of the procedural office of the clinic.

Chemical treatment methods

To get rid of the wart, applications of dairy-salty collidies and salicylic plaster are used.The percentage of drugs and the method of their use (long -term port of plaster, applications, etc.) depend on the prevalence and location of neoplasm.

Circus and 2-chlorpropionic acid solutions can also be used.In this case, the chemical composition is applied to the pre-transformed surface, which is left on the wart until the color changes (depending on the type of wart).The procedure is repeated several times after 7, 14 and 21 days.Before each procedure, the fabric is removed mechanically.

Another chemical method is a combination of nitrogen, acetic, oxalic, lactic acids and with copper nitrate trihydrates.In this way, only relatively small neoplasms are treated - up to 5 mm.The solution is also left until the color of the wart is modified.After 3 to 5 days, the patient comes to the control technique, if necessary, a second procedure is prescribed after 1 to 4 weeks.

Cryodestruction

This method consists in freezing the wart with liquid nitrogen: moistened swabs are pressed towards damaged skin (with the capture of surrounding tissues in several mm) for 1 to 5 minutes.The destruction of certain neoplasms requires several procedures with a four -week interval.

The main drawbacks of cryodestruction are its pain and the effect defined in relation to other methods in which only one procedure is often sufficient to be deleted.

Electrocoagulation

Under the influence of the electric current, the wart is removed according to the layers.Such an operation is carried out under local pain relievers.

This method is more effective than cryodestruction, but it has a less important: electrocoagulation often leaves scars instead of elimination of the wart.For patients who are sent to eliminate a cosmetic defect,This method will not be the most appropriate.

Laser destruction

Using a laser, warts are also deleted in layers.The Svetoper is in contact with the skin a few seconds to three minutes, depending on the size.Then the scabies that appeared is excised, and the bottom of the injuries treated with a laser.Then the patient is informed of the wound treatment methods.The operation itself is carried out under the influence of local anesthesia.

Radio wave surgery

Radio wave surgery is one of the most modern and softest methods to eliminate certain mild neoplasms, including warts.

The method is based on the generation of electromagnetic waves with different frequencies: from 100 kHz to 105 MHz.During the procedure, the tissues resist the passing waves, because of which molecular energy is released in cells, which heats the skin.Under the influence of heat, the cells really evaporate - a neat incision is obtained.At the same time, no mechanical effort is found on the affected tissue.

Advantages of this method:

• security;
• Rapid healing of the injury;
• Good cosmetic effect - Excluded scars and scars;
• Relative absence - a local pain relievers is used before mini -operation;
• Exclusion of secondary infection due to automatic electrode disinfection when the device is activated.

The effectiveness of this method is recognized throughout the world, however, it is quite difficult to find a clinic in which the radio-vague surgery method is used.

What is the treatment method to choose

All these methods have several drawbacks:

• During the first two weeks, the operated area has an unattractive appearance - crusts, darkening fabrics.This should be taken into account if the warts are on visible parts of the body (for example, on the face).
• An unpleasant odor and a certain degree of pain during surgery.

In addition, each of these methods has contraindications which must be found on the preliminary consultation of a dermatologist.

But the main one isHigh relapse probability, especially if the warts were common, extended.With each of these methods, doctors do not fight the deep cause of the disease, but with its consequences, because todayThe human papilloma virus cannot be healed.

Therefore, therapy is directed:

• or the destruction of neoplasms occurring on the site of the introduction of the virus;
• or to stimulate an antiviral immune response;
• or on the combination of these approaches.

Most often, destructive treatment methods are used.Their efficiency reaches 50 to 80%.

For surgical treatment methods, the age of children is generally not a contraindication.Therefore, many of them (including radio-vague surgery) are used to treat warts in children.An exception is the chemical elimination of warts due to the possibility of unwanted substance reactions.

What to do after surgery

After one of these operations, be sure to follow the recommendations of the attending physician.

After removing the neoplasm from one of the methods presented, the doctor generally prescribes the treatment of the place of elimination.It is forbidden to withdraw independently the "crusts", to wet the wound and to expose it to direct sunlight.

If the patient is constantly suffering from warts, he should consult an immunologist - he may require drug treatment, which will increase the resistance of immunity to manifestations of human papillomavirus.

Forecast.Prevention

If the patient has no immunodeficiency, warts can go through themselves, but it will need a lot of time - from several months to several years.Thus, in 65% of cases, warts regress independently for two years.If two years later, the wart is still on site, it is recommended to remove it.It is recommended to remove multiple neoplasms immediately.

With normal immunity and the properly selected elimination method (depending on the size and type of wart), it is possible to eliminate pathogenic tissues and obtain a good cosmetic effect.With reduced immunity and other predisposing factors, the human papilloma virus causes relapses.

The specific prevention of the disease does not exist.But is it so inevitable?

You can reduce the probability of a virus if you follow several rules:

• Do not go barefoot in public places where it is possible to injure the skin and infect yourself with a virus (swimming pools, public showers, gymnasiums).
• Choose high quality shoes, change it more often.Try to dry your legs.Heat and humidity are an excellent environment for the spread of the human papilloma virus.
• To avoid patronage warts, go to manicure only for certified masters and make sure they use sterile tools.

For the prevention of anogenital warts, according to the WHO (World Health Organization), a four -glorious vaccine of the human papillom virus is also very effective.For the prevention of other types of warts, vaccines currently do not exist.

If you find a wart, do not try to burn, cut it by yourself, cut it-so that you can contribute to inflammation and additional reinstallation of the skin virus.After such a "deletion" instead of a wart in the morning, you can wake up with ten.