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2016-04-29 19:07:55
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answer #3
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answered by ? 3
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Genital warts (or condyloma, or condylomata acuminata) is a highly contagious sexually transmitted infection. Caused by some variants of the Human papillomavirus, typically HPV 6 and HPV 11, it is spread during oral, genital, or anal sex with an infected partner. Genital warts (condylomata acuminata or venereal warts) are the most easily recognized sign of genital HPV infection. Of the multiple strains of genital HPV, strains 6, 11, 30, 42, 43, 44, 45, 51, 52, and 54 can cause genital warts (Gearhart et al, 2004). Most people who acquire those strains never develop warts or any other symptoms. HPV is also responsible for over 90% of all cases of cervical cancer. (However, the HPV strains responsible for cervical cancer differ from the strains that cause genital warts.)
Genital warts often occur in clusters and can be very tiny or can spread into large masses in the genital or anal area. In women the warts occur on the outside and inside of the vagina, on the opening (cervix) to the womb (uterus), or around the anus. While genital warts are approximately as prevalent in men, the symptoms of the disease may be less obvious. When present, they usually are seen on the tip of the penis. They also may be found on the shaft of the penis, on the scrotum, or around the anus. Rarely, genital warts also can develop in the mouth or throat of a person who has had oral sex with an infected person.
Treatment
Genital warts often disappear even without treatment. In other cases, they eventually may develop a fleshy, small raised growth. There is no way to predict whether the warts will grow or disappear.
Depending on factors such as the size and location of the genital warts, a doctor will offer one of several ways to treat them.
Imiquimod, (Aldara®) a topical immune response cream which can be applied to the affected area
A 20% podophyllin anti-mitotic solution, which can be applied to the affected area and later washed off
A 0.5% podofilox solution, applied to the affected area but should not be washed off
A 5% 5-fluorouracil (5-FU) cream
Trichloroacetic acid (TCA)
Pulsed dye laser
Liquid nitrogen cryosurgery
With pregnancy, podophyllin or podofilox should not be used as they are absorbed by the skin and may cause birth defects in the fetus. In addition, 5-fluorouracil cream should not be used while trying to become pregnant or if there is a possibility of pregnancy.
In case of small warts, they can be removed by freezing (cryosurgery), burning (electrocautery), or laser treatment. Surgery is occasionally used to remove large warts that have not responded to other treatment.
Some doctors use the antiviral drug interferon-alpha, which they inject directly into the warts, to treat warts that have returned after removal by traditional means. The drug is expensive, however, and does not reduce the rate that the genital warts return.
Although treatments can get rid of the warts, they do not get rid of the HPV virus, so warts can recur after treatment. The body's immune system typically clears the virus anywhere from 8 to 13 months, but it occasionally remains in the body for a lifetime.[1] The state of the immune system determines the chances of ridding the virus entirely and can be affected by factors such as HIV infection, certain medications, stress, or illness.[2] There is even some suggestion that effective treatment of the wart may aid the body's immune response[citation needed].
[edit] Prevention
The virus that causes genital warts is spread by skin-skin contact. Condoms do not adequately protect against genital warts, because the infected spot may not be covered by a condom. The only reliable prevention is to have no skin contact with potentially infected tissue.
Gardasil, an HPV vaccine, protects women from the strains of HPV that cause 70% of all cervical cancers and 90% of all genital warts and has been approved by the Food and Drug Administration.[3] The license allows prescription to females between the ages of 9-26. This vaccine is most effective when administered before the girl has contacted any of the HPV strains which the virus protects. For this reason, the vaccine should be preferably administered before a girl becomes sexually active. This vaccine is currently being tested for males.
[edit] Hirsuties papillaris genitalis
It is a common misconception among men that hirsuties papillaris genitalis are in fact genital warts. Hirsuties papillaris genitalis is not contagious and no treatment for the condition is necessary. Some may deem it unsightly and there are various methods of ridding the penis of the condition such as carbon dioxide laser treatment.
[edit] Fordyce's spots
Genital warts should not be confused with Fordyce's spots, which are considered benign.
[edit] Pregnancy and childbirth
Genital warts may cause a number of problems during pregnancy. Sometimes the warts get larger during pregnancy, making it difficult to urinate. If the warts are in the vagina, they can make the vagina less elastic and cause obstruction during child birth.
Rarely, infants born to women with genital warts develop warts in their throats (laryngeal papillomatosis). Although uncommon, it is a potentially life-threatening condition for the child, requiring frequent laser surgery to prevent obstruction of the breathing passages. Research on the use of interferon therapy in combination with laser surgery indicates that this drug may show promise in slowing the course of the disease.
A wart is generally a small, rough tumour, typically on hands and feet, that resembles a cauliflower. Warts are common, and are caused by a viral infection, specifically by the human papillomavirus (HPV). They typically disappear after a few months but can last for years and can recur. A few papillomaviruses are known to cause cancer. Certain types of warts, depending on location and cause, can be contagious from region to region, but are not transferable between species.
[edit] Types of wart
A range of different types of wart have been identified, which differ in shape and site affected, as well as the type of human papillomavirus involved.[1] These include:
common wart (verruca vulgaris): a raised wart with roughened surface, most common on hands and knees
flat wart (verruca plana): a small, smooth flattened wart, tan or flesh coloured, which can occur in large numbers; most common on the face, neck, hands, wrists and knees
filiform or digitate wart: a thread- or finger-like wart, most common on the face, especially near the eyelids and lips
plantar wart (verruca, verruca pedis): a hard sometimes painful lump, often with multiple black specks in the center; usually only found on pressure points on the soles of the feet
mosaic wart: a group of tightly clustered plantar-type warts, commonly on the hands or soles of the feet
genital wart (venereal wart, condyloma acuminatum, verruca acuminata): wart affecting the genital areas
[edit] Treatment
[edit] Prescription
Two viral warts on a middle finger, being treated with a mixture of acids (like salicylic acid, brand name Aporil®) to remove them. A white precipitation forms on the area where the product was applied.Treatments that may be prescribed by a medical professional include:
Keratolysis, removal of dead surface skin cells usually using salicylic acid, blistering agents, immune system modifiers, or formaldehyde.
Cryosurgery, which involves freezing the wart (generally with liquid nitrogen), after which the wart and surrounding dead skin falls off by itself. Surgical removal of the wart is sometimes also performed.
Laser treatment.
Imiquimod, a topical cream that helps the body's immune system fight the wart virus by encouraging interferon production.
Candida injections at the site of the wart, which also stimulate the body's immune system.[2]
Cantharidin, a chemical found naturally in many members of the beetle family Meloidae which causes dermal blistering.
None of these treatments are very effective on single uses except Cryosurgery; the wart often returns after the skin has healed from the treatment, but repeated treatment should get rid of the wart permanently. As they disappear after a few months and maximally a few years, treatment is necessary only if the lesions are painful or are a cosmetic problem.
One review of 52 clinical trials of various cutaneous wart treatments concluded that topical treatments containing salicylic acid were the best supported, with an average cure rate of 75% observed with salicylic acid compared with 48% for placebo in six placebo-controlled trials including a total of 376 participants.[3] The reviewers also concluded that there was little evidence of a significant benefit of cryotherapy over placebo or no treatment.[3]
[edit] Over-the-counter
There are also several over-the-counter options. The most common ones involve salicylic acid. These products are readily available at most drugstores and supermarkets. There are typically two types of products: adhesive pads treated with salicylic acid, or a bottle of concentrated salicylic acid. Removing a wart with this method requires a strict regimen of cleaning the area, applying the salicylic acid, and removing the dead skin with a pumice stone or emery board. It may take up to 12 weeks to remove a stubborn wart.
Another over-the-counter product that can aid in wart removal is silver nitrate in the form of a caustic pencil, which is also available at drug stores. This method generally takes three to six daily treatments to be effective. The instructions must be followed to minimize staining of skin and clothing.
Over-the-counter cryosurgery kits are also available, however they can often cost 3 times as much as the previously named products.
Like prescription treatments, over-the-counter treatments usually require multiple applications, and are only necessary if the warts are problematic. Additionally, these treatments are capable of destroying healthy skin as well as warts, so caution must be exercised by those attempting them without medical supervision.
[edit] Household remedies
Duct tape occlusion therapy involves placing a piece of duct tape (or medical tape) over the affected area for a week at a time. The procedure is otherwise identical to that of using salicylic acid adhesive pads. One study found that the duct tape method was 85% effective, compared to a 60% success rate in the study's cryotherapy group.[4] Another study, however, found no statistically significant effect. [5]
Other household remedies include the application of common household items, such as bruised garlic (held in place with a bandage or duct tape), banana skin, vinegar, hot water and washing liquid, aerosol sprays, tea tree oil and other natural oils, unskinned potatoes, potato or cauliflower juice, salt, or vegemite to the affected area. Milkweed or dandelion sap is also used. Anecdotal evidence suggests poison ivy can be effective (with extreme care). Accounts vary in regards to how long these remedies must be applied with each session and how long they take to work.
Without controlled studies for most household remedies, it is difficult to know whether the warts disappear because the remedies work, or if they disappear due to the individual's own immune system response to the virus (possibly augmented by a placebo effect). The success of hypnosis in curing warts[6] at least suggests that the condition may be cured by belief in a remedy, the placebo effect or other psychological means.
Some household remedies are potentially dangerous. These include attempts to cut or burn away the warts. Incense is sometimes used in Asian countries to burn warts. These methods are very painful, and can lead to infection and/or permanent scarring.
2007-03-02 04:51:17
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answer #10
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answered by Lauren S 2
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