What is a wart?The causes of the occurrence, diagnosis and treatment methods are analyzed in the article of a dermatologist with an experience of 37 years.
Determination of the disease.Causes of the disease
Wart-This are uneven light competence -body neoplasms of the skin in the form of a localized growth of the upper skin layer (epidermis) with papules (knots) or plaques.
The frequency of the appearance of warts in adults is 7-12 %in school children to 10-20 %.
Warts are very similar to other skin neoplasms.Usually, a person cannot determine the disease independently that it is therefore necessary to contact a dermatologist.
The cause of the appearance of warts is the human papilloma virus.A large number of warts that can develop depends on the type of virus.Every kind of human papilloma virus influences the tissue on the localization of the characteristic.
| Type of HPV | Extremely Localization |
Types of warts |
|---|---|---|
| 1 | Feet, knees, palms, Brush, finger |
Subanaria and Palmar warts, Occasionally - simple warts |
| 2, 4 | Hands, fingers, knees, Less frequent - steps |
Simple warts, Occasionally - Plantar, Palmar and mosaic warts |
| 3, 10 | Shin, hands, face | Flat warts |
| 7 | Brush, finger | Butcher warts |
| 5, 8, 9, 12, 14, 15, 17, 19-24 |
Face, hands, The front of the body |
Periodymic epidermodysplasia |
An infection with a virus usually occurs in a contact path - with direct contact with infected and healthy skin (for example with a handshake) or indirect (by handrails, toys, etc.).Therefore, it is possible to have infected yourself with the human papillomavis virus in a variety of places in public transport, at school, at work, in houses, in places with high contact and damp environment (pools, saunas, gyms).Small injuries to the epidermis, viruses and the inflammation of the skin, contribute to infection.
The appearance of warts also carries:
- Immune weakness (including HIV infection);
- Warm and moist surroundings;
- The need for professional contact with meat and fish ("butcher warts").
Some types of human papilloma virus are transmitted by the parents.
But, despite the horror stories that are so often afraid in childhood, they cannot infect themselves - this is one of the most popular myths about this disease that has no reason.
If similar symptoms are found, consult a doctor.Do not do yourself - it is dangerous for your health!
Symptoms of warts
Depending on the type of wart, the symptoms vary.
Ordinary wart:
- Round dense papel of a conventional color with a size of 1-10 mm and larger.
- The surface of the papula is covered with cracks and layers.
- When the father is on the finger, the impression disappears and distorted.The same applies to the drawing of the palm.
- Simple warts are both single and several parts - normally they appear in places with the greatest injuries (hands, fingers, knees).
- During the examination with a dermatoscope, the doctor can see small brown dots - thrombed (blocked) capillaries.Patients often call such points "roots".This is the main feature for the doctor: the dermatologist can distinguish a wart from other similar diseases (e.g. contagious molluscus and keratoma).
Social (horn) wart:
- The main symptom, the patient of which is usually a doctor when pressing and consulting a doctor.
- Such warts are usually located on the feet.
- If you usually contact a doctor, a keratized uneven plaque of the usual color is visible, although you can see a uniform smooth papel in the first stage.With keratisation, the capillaries can only recognize if they remove the keratized skin layer.
- The skin pattern is distorted.
- Typically, plant arteries are single, but there are 2-6 parts;
- These warts are often confused with a corn (especially with dry) - with this description of the problem, the patients usually come to the reception.
Flat (youngsters) wart:
- In appearance, this is a round, clear, smooth papul from normal, pink or brownish 1-5 mm.
- Appears on the hands, lower legs, very often on the face.
- There are always several such warts - they are in groups.
EpiderModisplasia from Verrucilia (Senile Warte):
- Large round numerous merging neoplasms from normal, pink or brown.
- Most of the time appear on the face, hands, front side of the body.
- They can be confused with keratoma, lichen and skin cancer.
Pathogenesis of warts
If the human papillomavirus penetrates the body in a latent state for a long time, a person usually doesn't even know about their existence.When factors for the virus appear to be favorable, it begins to "multiply" in the epithelium, which leads to a change in the tissue.
In contrast to other viruses, the human papillomavirus does not destroy the cells of the epithelium - of course they die alone - in the process of keratization and peeling.
The spread of the infection is influenced by local factors and the condition of the immune system.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 that many people have warts after a few months.
The main stage when warts occur is to accelerate the splitting and cell growth with a virus.Such a quick metabolism leads to thickening of the skin layers.Since the fabrics grow in a certain small area, a tubercle occurs, which is referred to as warts.
Classification and levels of wart development
There is no generally recognized classification of warts.However, some frequently occurring varieties can be distinguished:
- Ordinary wart- The most common type (70 % of the warts are exactly them).Such neoplasms cannot be felt and cause only aesthetic symptoms.
- Social wart- It seems painful on your feet, hence treatment.The appearance of such a wart is made easier by skin injuries by unpleasant, cramped, smooth shoes.
- Flat warts- They appear more often in young people, young people.This is due to the unstable hormonal background of young people who affect the whole body.Usually flat warts are almost invisible.
- Senile warts- Inherent for older people.Often appear on parts of the body that are covered with clothing but can meet on the face and hands.If there is no discomfort, it is not worth treating such warts healing in older people who can be much slower due to the slow metabolism, which is in young people.
Other authors distinguish several more from these types of warts:
- Mosaic warts(HPV 2, 4) - Neoplasms on the palms and soles.They look like hyperkeratosis, i.e. thickening of the layer of layers of the skin (usually in the front 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, a white -sail load appears, similar to cottage cheese.
- Film warts- Dünne Horn -Growth near the mouth, nose or eyes.
- Warts "butcher"(HPV 7) - appear in the hands and fingers of people who are constantly in contact with meat and fish.In the form of hypertrophic neoplasms, they become similar to cauliflower, but normal color.
In addition, the waiting types differ depending on their localization.
Therefore, one often becomes in.Tumor -defined neoplasms that occur on the genitals (especially in the skin crossing to the mucus membrane) frequently found.Usually they are caused by HPV 6 and 11.
Complications of warts
The main reason why patients go to the doctor with warts is an aesthetic defect that can influence the quality of the patient's life, his self -confidence and develop many complexes.The complications also include cracking the surface of the wart and connecting the infection and some types of warts - pain when walking.
In malignant neoplasia, skin warts are usually not reborn, they are quite harmless, but in very rare cases, such a complication in people with oppressed immunity can still occur.
Other complications occur when they try to remove neoplasms independently.In this regard, inflammation and aesthetic defects can occur in the form of scars, as well as the further spread of the virus on the skin, which is why a person can wake up with several new ones in the morning after the removal of a wart.
Remember that a completely different disease can be hidden under the guise of the warts, which cannot be determined without consulting an experienced doctor.
Diagnosis of warts
To make a diagnosis, there is usually enough inspection (clinical picture) and a collected medical history (medical history).
In order to confirm the diagnosis, the doctor can carry out a histological study - the examination of neoplasma cells.
It is very important to carry out differential diagnosis - to distinguish warts from other diseases.For example,Ordinary wartsIt is necessary to distinguish from the following diseases:
- Contagioine Mollusk- more often on the body and genitals, less often on hands and feet.It is a hemisphere with pressing on the surface when pressed from the sides, emphasizes the whitish "porridge".
- Epidermal Warmnevus- Frequently lonely, one person has from birth.It rises above the skin surface, often covered with hair.
- Bazaliom- A tumor in the form of a role of nodules in the middle is covered with a crust.Inherent for older people.
Ladomarly supported wartsIt is necessary to distinguish from the following diseases:
- Keratoderma- Large areas of keratization and inflammation of the skin.There are no shabby capillaries.
- Ladomar transmitter- Several painless neoplasms along the periphery are the skin.The reaction to syphilis is positive.
- corn- Usually painless, can only cause pain through vertical pressing.
The doctor should also distinguish the remaining waiting types from a number of diseases.In the event of distrust of another pathology, it can prescribe additional diagnostics (e.g. the identification of antibodies for viruses, CT or MRI).
Treatment of warts
Warts are treated for aesthetic purposes and to improve the patient's quality of life.It can only be prescribed by a doctor after the examination and a precise diagnosis.Independent attempts to get rid of the wart are unacceptable because the patient cannot determine the disease precisely without medical training and the required equipment, and complications after such "treatment" are much more common than recovery.
There are different treatment methods for the treatment of warts.All of them are usually 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 warts, applications of milk-salicyl-collidia and salicylplasters are used.The percentage of drugs and the method of their use (long -term wearing plasters, applications, etc.) depend on the prevalence and localization of the neoplasm.
Circus and 2 chlorine propionic acid solutions can also be used.In this case, the chemical composition is applied to the pre -processed surface, which remains on the wart until the colors are changed (depending on the type of wart).The procedure is repeated several times after 7, 14 and 21 days.The fabric is removed mechanically before each procedure.
Another chemical method is a combination of nitrogen, acetic acid, oxal, lactic acids and copper nitrate -Trihydrate.In this way, only relatively small neoplasms are treated - up to 5 mm.The solution also remains until the color of the wart has changed.After 3-5 days, the patient comes to control technology if necessary, and he is prescribed a second procedure after 1-4 weeks.
Cryodestry
This method is to freeze the wart with liquid nitrogen: a diligent swab is pressed to damaged skin (with the use of surrounding tissues in several mm) for 1-5 minutes.The destruction of some neoplasia requires several procedures with an interval of four weeks.
The main disadvantages of cryodestruction are your pain and the defined effect compared to other methods in which only one procedure is sufficient to remove.
Electrical clearing
Under the influence of the electrical current, the wart is removed according to the layers.Such an operation is carried out under local painkillers.
This method is more effective than cryodestruction, but has a significant minus: electrocoagulation often leaves scars at the place of removal of the wart.For patients who are ancestrated to eliminate a cosmetic defect,
This method is not the most suitable.
Laser disorder
Warts are also removed in layers with the help of a laser.Depending on the size of a few seconds to three minutes, the Svetoper is in contact with the skin.Then the scab that appeared is cut and the bottom of the wounds is treated again with a laser.Then the patient will be dependent on the processing methods of the wound.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 gentlest methods to remove some benign neoplasms, including warts.
The method is based on the production of electromagnetic waves with different frequencies: from 100 kHz to 105 MHz.During the procedure, the tissue resist the temporary waves, which releases molecular energy in the cells that heat the skin.The cells actually evaporate under the influence of heat - a decent cut is preserved.At the same time, there are no mechanical efforts on the affected fabric.
Advantages of this method:
- Security;
- Quick healing of the wound;
- Good cosmetic effect - excluded scars and scars;
- Relative painlessness-local analgesic is used before the mini operation;
- Exclusion of a secondary infection due to the automatic disinfection of the electrode when the device is switched on.
The effectiveness of this method is recognized worldwide.However, it is quite difficult to find a clinic in which the method for radio wave surgery is used.
What is the treatment method to choose?
All of these methods have several disadvantages:
- In the first few weeks, the area operated has an unattractive appearance - crusts, darkening of the fabrics.This must be taken into account if the warts are on visible parts of the body (e.g. on the face).
- An unpleasant smell and a certain level of pain during the operation.
In addition, each of these methods has contraindications that have to be found for the preliminary consultation of a dermatologist.
But the main minus isHigh probability of relapse, especially when the warts were common.With each of these methods, doctors do not combat the basic cause of the disease, but with their consequences since todayThe human papilloma virus cannot be healed.
Therefore, the therapy is directed:
- or the destruction of neoplasms that arise in the place of the introduction of the virus;
- or stimulate an antiviral immune response;
- Or on the combination of these approaches.
Destructive treatment methods are usually used.Their effectiveness reaches 50-80 %.
For surgical treatment methods, the age of children is usually not a contraindication.Therefore, many of them (including radio wave surgery) are used to treat warts in children.An exception is the chemical removal of warts due to the possibility of disadvantageous reactions to the substance.
What to do after the operation
After one of these operations, be sure to follow the recommendations of the treating doctor.
After removing the neoplasm of one of the methods presented, the doctor usually prescribes the processing of the distance.It is forbidden to remove "crusts" independently, to wound the wound and to expose it to direct sunlight.
If the patient is constantly suffering from warts, he should consult an immunologist-it can require drug therapy that increases the resistance of immunity against manifestations of human papillomavirus.
Forecast.prevention
If the patient has no immune deficiency, warts can pass on, but this requires a lot of time - from several months to several years.In 65 % of cases, the warts are reduced independently for two years.If the wart is still on site two years later, it is recommended to remove it.It is recommended to remove several neoplasia immediately.
With normal immunity and the correctly selected distance method (depending on the size and type of wart), pathogenic can remove tissue and achieve a good cosmetic effect.The human papilloma virus causes relapses with reduced immunity and other predisposing factors.
There is no specific prevention of the disease.But is it so inevitable?
You can reduce the likelihood of a virus if you follow several rules:
- Go barefoot in public places where it is possible to hurt the skin and infect with a virus (pools, public showers, gyms).
- Choose high -quality shoes, change it more often.Try to dry your legs.Heat and moisture are an excellent environment for the spread of the human papilloma virus.
- To avoid patronage warts, only go to manicure to certified masters and make sure that you use sterile tools.
According to the WHO (World Health Organization), a four -class vaccine from the human papilloma virus is also highly effective for the prevention of anogenital warts.There are currently no vaccines to prevent other types of warts.
If you find a wart, don't try to burn, cut it off yourself, cut it off - so you can contribute to inflammation and further resettlement of the skin virus.After such a "distance" instead of a wart in the morning you can wake up with ten.