What is a wart?The causes of occurrence, diagnosis and treatment methods will be analyzed in the article by a dermatologist with a 37 -year experience.
Determination of the disease.Causes of the disease
Wart-Tests are uneven neoplasms benign skin 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 school children to 10-20 %.
Warts are very similar to other skin neoplasms.Generally, a person cannot independently determine the disease independently, so to make a diagnosis, it is necessary to contact a dermatologist.
The cause of the appearance of warts is human papillomavirus.A variety of warts that can develop depends on the type of viruses.Therefore, each type of human papilloma virus affects the fabric in its most characteristic location.
| HPV type | Extremely location |
Types of Warts |
|---|---|---|
| 1 | Feet, knees, palm trees, Brushes, fingers |
Subanaries and Palmares warts, Occasionally - Simple Warts |
| 2, 4 | Hands, fingers, knees, Less Commonly - Passos |
Simple warts, Occasionally - Plant, Palmar and mosaic warts |
| 3, 10 | Cinnamon, hands, face | Flat warts |
| 7 | Brushes, fingers | Butcher warts |
| 5, 8, 9, 12, 14, 15, 17, 19-24 |
Face, hands, In front of the body |
Verruchimic epidermodysplasia |
Infection with a virus usually occurs on a contact path - with direct contact of the infected and healthy skin (for example, with handshake) or indirect (through handrails, toys, etc.).Therefore, it is possible to be infected with the human Papillomavis virus in a wide variety of places - in public transport, at school, at work, houses, in places with high contact and humid environment (swimming pools, saunas, gyms).Small lesions of the epidermis through which viruses, as well as skin inflammation, contribute to infection.
In addition, the appearance of warts contributes to:
- immunodeficiency (including HIV infection);
- hot and humid environment;
- The need for professional contact with meat and fish ("butcher warts").
Some types of human papilloma viruses are transmitted from parents.
But frogs and frogs, despite the horror stories that are often scared in childhood, you can't be infected - this is one of the most popular myths about this disease that has no reason.
If similar symptoms are detected, consult a doctor.Don't be self -service - it's dangerous for your health!
Wart symptoms
Depending on the type of wart, symptoms vary.
Common wart:
- Round dense papule of a conventional color with size from 1 to 10 mm and larger.
- The surface of the book is covered with cracks, layers.
- If the father is on the finger, the impression disappears and distorts.The same applies to palm design.
- Simple warts are located and several pieces - usually appear in places of greater injury (hands, fingers, knees).
- When examining with a dermatoscope, the doctor can see small brown points - trusted capillaries (clogged).Patients usually call these points "roots".This is the doctor's main feature: the dermatologist can distinguish a wart from other similar diseases (eg contagious mollusk and keratomas).
Social Wart (Horn):
- The main symptom because the patient usually consults a doctor is pain when pressing and walking.
- Such warts are usually located on the feet.
- Upon contact with a doctor, as a rule, a keratinized irregular plate of the usual color is visible, although in the first stage you can see a still smooth papula.With keratinization, capillaries can only be seen if you remove the keratinized layer from the skin.
- The skin pattern is distorted.
- Usually the plantar warts are single, but there are 2-6 pieces;
- Often, these warts are confused with a corn (especially with dry) - with this description of the problem problem, patients usually reach the reception.
Flat Wart (young):
- In appearance, this is a round, light and smooth, normal, pink or brownish papula 1 to 5 mm.
- It appears in the hands, legs, often on the face.
- There are always several warts - they are located in groups.
Epidermodisplazia of Verrucilia (Senil Wart):
- Large numerous fusion neoplasms of normal, pink or brown.
- Most of the time it appears on the face, hands, side of the front of the body.
- You can confuse with Keratoma, Lichen and Skin Cancer.
Pathogenesis of warts
If human papillomavirus enters the body in a latent state for a long time - a person usually doesn't even know about his existence.When the factors seem favorable to the virus, it begins to "multiply" in the epithelium, leading to a change in tissues.
Unlike other viruses, human papillomavirus does not destroy the epithelium cells - they die on their own, of course - in the process of keratinization and exfoliation.
The dissemination 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.Also, these neoplasms are usually difficult to treat.With normal immunity, the virus does not affect the deepest layers of the skin, many people have warts on their own after a few months.
The main stage of the appearance of warts is to accelerate the rate of division and cell growth with a virus.Such a fast metabolism leads to the thickening of the skin layers.Since tissues grow in a certain small area, there is a tuber, which is called wart.
Classification and stages of the development of wart
There is no universally recognized classification of warts.However, several frequently found varieties can be distinguished:
- Common 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- appears in the feet, painful, therefore, requires treatment.The occurrence of a wart is facilitated by skin lesions due to uncomfortable, tight and rubbing shoes.
- Flat warts- More often they appear in young people, teenagers.This is due to the unstable hormonal background of young people, which affects the whole body.Usually flat warts are almost invisible.
- Senis Warts- Inherent to the elderly.They often appear in body parts, covered with clothes, but can meet on the face and hands.If there is no discomfort, it is not worth treating these warts in the elderly, it may occur much slower, which is in young people, due to slow metabolism.
Other authors distinguish several other types of warts:
- Mosaic warts(HPV 2, 4) - neoplasms on palm trees and soles.They look like outbreaks of hyperkeratosis, ie thickening of the skin stratum layer (usually on the front of the foot), covered with deep cracks.
- Cystic warts(HPV 60) - A very rare type of neoplasia in the foot.It is a soft knot with cracks.When opening, the yellow-white discharge appears, similar to cottage cheese.
- Movie warts- Fine growth of the horn near the mouth, nose or eyes.
- Warts "butchers"(HPV 7) - Appears in the hands and fingers of people who are constantly in contact with meat and fish.They are presented in the form of hypertrophy neoplasms similar to kale -flower, but normal color.
In addition, the types of warts are distinguished, depending on their location.
Thus, an Angontal Wart is often found - tumor -shaped neoplasms that appear in the genital organs (especially in places of skin transition to the mucous membrane).Usually they are caused by HPV 6 and 11.
Wart complications
The main reason why patients with warts go to the doctor is an aesthetic defect that can affect the patient's quality of life, self -confidence and develop many complexes.Complications also include cracks on the surface of wart and union of infection and with some types of warts - pain during walking.
In malignant neoplasms, cutaneous warts usually do not reborn, they are quite harmless, but in very rare cases, this complication can still occur in people with oppressed immunity.
Other complications appear when trying to remove independently the neoplasms.In this sense, inflammation and aesthetic defects may occur in the form of scars, as well as the additional spread of the virus on the skin, which is why a person can wake up with several new mornings after the independent removal of a wart.
Remember that under the disguise of warts, a completely different disease can be hidden, which cannot be determined without consulting an experienced doctor.
Diagnosis of wart
Usually, to make a diagnosis, there is sufficient inspection (clinical image) and a collected story (medical history).
To confirm the diagnosis, the doctor can perform a histological study - the study of neoplasia cells.
It is very important to make differential diagnosis - distinguish warts from other diseases.For example,Common wartsIt is necessary to distinguish from the following diseases:
- Contagioine mollusco- More often appears in the body and genital organs, with less frequency in the hands and feet.It is a hemisphere pressed on the surface, when pressed by the sides, the whitish "gruel" stands out.
- Nevus of epidermal wart- More frequently lonely, a person has since birth.It rises above the surface of the skin, usually covered with hair.
- Bazalioma- A tumor in the shape of a roll of nodules, in the center is covered with a crust.Inherent to the elderly.
Warts supported by boysIt is necessary to distinguish from the following diseases:
- Keratoderma- Large areas of keratinization and inflammation of the skin.There are no shabby capillaries.
- Ladomary-Sifilids- Multiple painless neoplasms along the periphery, the skin is lying down.The reaction to syphilis is positive.
- Corn- Usually painless, can cause pain only with vertical pressing.
The doctor should also differentiate the remaining types of warts from various diseases.In case of suspicion of another pathology, it may prescribe additional diagnoses (for example, the identification of antibodies for virus, CT or magnetic resonance imaging).
Wart Treatment
Wart treatment is performed for aesthetic purposes and to improve the patient's quality of life.It can be prescribed only by a doctor after the examination and an accurate diagnosis.Independent attempts to get rid of wart are unacceptable, as the patient without medical education and the necessary equipment is not able to accurately determine the disease, and complications after this "treatment" occur much more often than recovery.
There are several treatment methods for the treatment of warts.All of them are usually performed under the supervision of a doctor and some of them - only under the conditions of the clinic's procedural office.
Chemical Treatment Methods
To get rid of the wart, collidia applications of salicylic dairy and salicylic plaster are used.The percentage of medicines and the method of use (long -term use of implase, applications, etc.) depend on the prevalence and location of the neoplasia.
Circus and 2-chlorpropionic acid solutions can also be used.In this case, the chemical composition is applied to the pre -processed surface, which is left in 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 tissue is mechanically removed.
Another chemical method is a combination of nitrogen, acetic, oxal, lactic and tri -copper nitrate hydrade acids.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 changed.After 3-5 days, the patient arrives at the control technique, if necessary, he receives a second procedure after 1-4 weeks.
Cryodestruction
This method consists of freezing the wart with liquid nitrogen: a moistened cotton swab is pressed to the damaged skin (with the capture of surrounding tissues in several mm) for 1-5 minutes.The destruction of some neoplasms requires several procedures with a four -week interval.
The main disadvantages of Criodestrification are their pain and the defined effect compared to other methods in which only one procedure is sufficient to remove.
Electrocoagulation
Under the influence of the electric current, the wart is removed according to the layers.This operation is performed under local painkillers.
This method is more effective than criodestruction, but has a significant less: electrocoagulation usually leaves scars at the wart removal site.For those patients who are addressed to eliminate a cosmetic defect,
This method will not be the most appropriate.
Laser destruction
With the help of a laser, warts are also removed in layers.Svetoper is in contact with the skin from a few seconds to three minutes, depending on the size.Then the crust that appeared is excited and the bottom of the wounds treated again with a laser.Then the patient is instructed on wound processing methods.The operation itself is performed under the influence of local anesthesia.
Radio wave surgery
Radio wave surgery is one of the most modern and soft methods to remove some benign 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, due to which molecular energy is released in cells, which heat the skin.Under the influence of heat, cells actually evaporate - a pure incision is obtained.At the same time, no mechanical effort is in the affected fabric.
Pros of this method:
- security;
- rapid wound healing;
- Good cosmetic effect - excluded scars and scars;
- Painly relative-a local painkiller 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 worldwide, however, it is quite difficult to find a clinic in which the method of radio wave surgery is used.
What is the treatment method to choose
All these methods have several disadvantages:
- In the first two weeks, the operated area has an unattractive appearance - crusts, darkening of fabrics.This should be taken into consideration if the warts are in visible parts of the body (eg face).
- An unpleasant odor and some degree of pain during surgery.
In addition, each of these methods is against -indications that need to be discovered about the preliminary consultation of a dermatologist.
But the main least isHigh probability of relapseespecially if the warts were common, extensive.With each of these methods, doctors do not combat the root cause of the disease, but with their consequences, because todayThe human papilloma virus cannot be healed.
Therefore, the therapy is directed:
- or the destruction of neoplasms that arise at the site of the introduction of the virus;
- or stimulate an antiviral immune response;
- or in the combination of these approaches.
Most of the time, destructive treatment methods are used.Its effectiveness reaches 50-80 %.
For surgical treatment methods, the age of children is usually not a against -Indication.Therefore, many of them (including radio wave surgery) are used to treat warts in children.One exception is the chemical removal of warts due to the possibility of adverse reactions to the substance.
What to do after surgery
After any of these operations, follow the assistant doctor's recommendations.
After removing the neoplasia from any of the methods presented, the doctor usually prescribes the processing of the removal site.It is forbidden to independently remove "crusts", wet the wound and expose it to direct sunlight.
If the patient is constantly suffering from warts, he should consult an immunologist can require drug therapy, which will increase immunity resistance to human papillomavirus manifestations.
Forecast.Prevention
If the patient has no immunodeficiency, warts may go through their own, but it will need a long time - 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 that several neoplasms be removed immediately.
With normal immunity and the correctly selected removal method (depending on the size and type of wart), it is possible to remove the pathogenic tissue and get a good cosmetic effect.With reduced immunity and other predisposing factors, the human papilloma virus causes relapses.
Specific disease prevention does not exist.But is it so inevitable?
You can reduce the probability of a virus if you follow multiple rules:
- Do not be barefoot in public places, where you can hurt the skin and infect with a virus (swimming pools, public showers, gyms).
- Choose high quality shoes, change more often.Try to let your legs dry.Heat and humidity are an excellent environment for the spread of the human papilloma virus.
- To avoid sponsorship 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 papilloma virus is also highly 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 on your own, cut -o -so that you can contribute to inflammation and additional resettlement of the skin virus.After a "removal" instead of a wart in the morning, you can wake up with ten.