13- Clinical presentation and treatment of human papilloma virus infections

What does HPV cause

• High risk: cervical cancer

• Low risk- condyloma acuminatum

What is the transmission of HPV

• Trasmision- skin to skin, sexual intercourse

• Incubation period 6-12 months

What is the therapy for HPV

• No specific therapy

• Vaccination- Gardasil 9

  • Previous HPV vaccination is not contraindicated

  • No need for previous HPV screening

  • Ongoing HPV infection is not contraindicated

  • Can be prescribed any physician

What are the benign lesions caused by HPV

• verruca vulgaris/ common warts

• verruca plantaris/ plantar wards

• verruca plana/ flat warts

• conduloma acumilatum/ genital warts

Describe verruca vulgaris

• Causes 70% of all warts

• Lesions seem as firm papules 1-10mm, hyperkeratotic- thickening of str. Corneum, with cleft surface and vegetations

• Sometimes red/ brown dots- thtrombosed capillary loops can be seen in the lesions

• Lesions located in site of contact -> hands/ fingers

Describe verruca plantaris

• Lesions of the feet

• Usually flat lesions

• Resemble verruca vulgaris

• Can be tender or painful

Describe verruca plana

• Less common lesions that are very small, flat, sharply defined papules

• Seen in face or back of hands

Describe conduloma acuminatum

• Appear in the genital area

• HPV 6, 11

What is the treatment of benign lesions

• Not too aggressive- can spontaneously regress

• Can use cryotherapy with liquid nitrogen, electrosurgery, CO2 laser therapy, salicylic acid

What are the malignant lesions of HPV

• Cervical carcinoma- HPV 16,18

• SCC of head + neck- HPV 16,18