Condylomata acuminata are considered a sexually transmitted disease caused by papillomavirus infection and manifested by nodular skin proliferations. Across Europe, approximately 1 to 2 percent of the sexually active population of Condylomata acuminata are affected, with the age peak between the 20th and 24 Years.

What is Condylomata acuminata?

Condylomate acuminate are benign skin growths. They are recognizable by their typical shape, reminiscent of normal warts.
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As condylomata acuminata (also called genital warts, condylomas) are benign (benign) nodular growths of the skin the size of a pinhead, which are caused by an infection with human papillomavirus (HPV) and which is usually affected by the anogenital area.

In most cases, the infection triggers next to the wrinkled-looking, red-brownish or greyish-white skin growths that can lead to pruritus (itching), discharge or burning, no further discomfort. On the other hand, the psychological stress and impairment of the sexual life is to be estimated as much larger.

Women are mostly affected in the area of ​​the entrance to the vagina, the cervix (uterine cervix) and more rarely the urethral orifice, while men are primarily affected by the glans penis, foreskin, anus and urethral orifice and condyloma acuminata.

causes

Condylomata acuminata is caused by human papillomaviruses (HPV), in particular by the serotypes 6 and 11, in rare cases also by the types 16 and / or 18, which are usually due to unprotected sexual contact or a smear infection (inter alia contaminated sex toys) are transmitted to the skin.

In the process, the viruses first colonize the upper layers of the skin, into which they pass via small lesions in the skin or mucous membrane of the rectum, rectum, vagina or penis. In a weakened immune system as a result of HIV, immunosuppressive medication or drug abuse they can multiply and cause tissue growths with warts.

Fungal infections, genital herpes or eczema additionally favor infection. In addition, an infected mother may infect her newborn child with papillomaviruses during labor and cause condylomata acuminata.

Symptoms, complaints & signs

Condylomate acuminate are benign skin growths. They are recognizable by their typical shape, reminiscent of normal warts. Genital warts reach the size of a pinhead, occasionally they get bigger. They are reddish to brownish or gray-white discolored and usually occur in several groups that are close together.

These areola beds typically cause severe itching associated with hypersensitivity and possibly even bleeding. They usually occur in the genital area or on the feet. In women, they usually grow on the labia, at the entrance of the vagina, in the cervix or in the urethra mouth. In men, they arise mainly on foreskin, glans, anus, urethra and rectum.

In the absence of treatment, genital warts can spread to other parts of the body. When the genital warts are opened, a purulent discharge escapes, which usually smells unpleasant. Condylomas may be accompanied by a sense of illness. Some sufferers complain of fever, nausea and vomiting and other symptoms that always depend on the causative disorder.

Mostly, genital warts go hand in hand with mental illness. The skin growths are accompanied by a cosmetic blemish. Those affected are often ashamed and withdraw from social life. In the process, serious emotional problems such as fears, inferiority complexes, feelings of guilt or depression can develop.

Diagnosis & History

As a rule, Condylomata acuminata can be diagnosed on the basis of the skin condition or the characteristic formation of warts in the anogenital area. With the help of the so-called acetic acid test, the affected areas can be localized as white discolored areas.

An HPV DNA test and a PCR (polymerase chain reaction) allow the detection of specific papillomaviruses. A biopsy followed by histological analysis will confirm the diagnosis. An endoscopic examination can rule out an intra-anal or intrarectal infection.

In differential diagnosis, the disease should be differentiated from fibroma and squamous cell carcinoma of the genital area as well as from precancerous lesions and certain types of hirsuties. Condylomata acuminata usually show a good course with very good prognosis, with recurrences are not uncommon. The risk of cervical cancer is considered low in the HPV types, which cause predominantly Condylomata acuminata.

complications

In most cases it comes through the condyloma acuminata to the so-called genital warts on the genitalia. These are strong growths, which are associated with relatively strong and burning pain and thus extremely reduce the quality of life of the patient. Likewise, there is a strong itching on the genitalia, which is associated with redness.

As a result of the symptoms, sexual desire drops enormously, which can also lead to depressive moods and other mental health problems. Since the symptoms are relatively characteristic, an early diagnosis of the disease is possible, so that the treatment can be started early. The treatment itself is symptomatic and especially relieves the symptoms.

Creams, ointments and medicines are used, with no further complications. The growths can be removed with the help of surgical interventions. However, a renewed illness is not prevented. As a rule, complications can only occur if the disease is not treated and spread to neighboring regions. Early treatment always leads to a positive course of the disease.

When should you go to the doctor?

For condylomate acuminata, it is not necessary to consult a doctor. In most cases, genital warts do not cause any discomfort and resolve themselves after some time. However, if the growths bleed, wet, itch or cause other discomforts, medical advice is needed. Even warts that grow or multiply quickly are best examined by a specialist and treated if necessary. Genital warts, which occur for no apparent reason or keep coming back, indicate a serious illness - in this case necessarily talk to the family doctor.

Children and the elderly should always go to the doctor for condylomate acuminata to rule out serious conditions and complications. The same applies to patients with atopic dermatitis or other skin diseases. If you have ever been infected with HP viruses, it is best to consult a general practitioner if you come back. Further contacts are the dermatologist, urologist or gynecologist. If the condylomate acuminata greatly affect the well-being and are an emotional burden, should be accompanied by a therapist.

Treatment & Therapy

The therapeutic measures depend on Condylomata acuminata primarily on the extent of infection and localization. In the case of infestation of the outer skin layers, solutions or ointments or creams with podophyllotoxin (cytostatic), silver nitrate, epigallocatechin gallate contained in green tea or imiquimod, an antiviral stimulating the body's own defense, are generally recommended for topical application over several weeks,

However, the cell division inhibiting podophyllotoxin should not be used during pregnancy. If internal infections are present on the mucous membranes of the vagina, anal canal or urethral orifice, treatment with trichloroacetic acid applied to the affected areas at weekly intervals may be indicated.

In addition, the skin growths can be frozen by liquid nitrogen cryotherapy. In both cases, a local anesthetic can be applied because of the accompanying pain. In bed-type or pronounced growths as well as recurrences, surgery can be considered. Here, the genital warts are removed either with the help of a curette (including a sharp spoon) or in the context of an electrocautery (heat-generating electric current) or laser therapy under local or general anesthesia.

Optionally, photodynamic therapy (PDT) using 5-aminolevulinic acid may also be used. In case of recurrent recurrences, therapy with interferon-beta containing gels may be indicated to prevent re-appearance of condylomata acuminata.

Outlook & Forecast

The prospect of healing in Condylomata acuminata depends on the time of diagnosis and the start of treatment. There is no spontaneous healing and alternative healing methods are ineffective. The prospect of a recovery can only be made through a medical treatment. With early medical care, a good prognosis is possible.

The skin abnormalities are removed in surgery and a subsequent treatment for human papillomavirus (HPV) clearance is initiated. If the procedure is favorable, the patient can be discharged as symptom-free within a few weeks. For permanent healing, protection against re-infection of the HPV is necessary.

If the growths have already spread, the risk of a malignant disease process increases. The genital warts can lead to the formation of metastases. There is a possibility that cancer cells will detach and spread through the bloodstream in the organism. In severe cases, organs or other parts of the body are affected by cancer. For the patient, this situation represents a potential mortal danger.

The condylomata acuminata has a high recurrence rate. People who are infected with HPV are at high risk of re-emergence of the genital warts. Diseased people with condylomata acuminata were also more susceptible to recurrence than other patients.

prevention

An infection with HP viruses and concomitantly also Condylomata acuminata can be prevented by protected sexual intercourse or the use of condoms as well as by a prophylactic vaccination against HP viruses. In addition, direct contact with infected skin areas should be avoided. As a rule, partners of affected persons should also be examined for condylomata acuminata in order to rule out a ping-pong infection (mutual reinfection).

aftercare

The occurrence of Condylomata acuminata is rarely, if ever, complete. On the contrary, degeneration of the condyloma is possible in the long run. In many cases, the condylomas become cancerous. This worsens the prognosis. For this reason, a close and sufficiently frequent aftercare of the affected patients is essential.

After surgical intervention or ointment treatment, the follow-up examinations are carried out at intervals of three to four weeks. Later, the intervals between individual follow-up examinations can be increased. With proper treatment and a meaningful therapy, the chances of recovery are quite good. The problem, however, is that even surgical removal of the genital warts does not provide 100% certainty of recurrence. The reason for this lies in the viral causation of Condylomata acuminata. Only their visible consequences can be removed.

In the postoperative aftercare is often discovered that there is again a smaller infestation with genital warts. Since it can not be sensible to proceed surgically with every recurrence, therapy with antiviral ointments or solutions makes sense in this case. If necessary, Condylomata acuminata also requires immediate surgical intervention. The purpose of a close follow-up is to prevent difficult progressions. The involvement of papilloma vaviruses involves the risk of degeneration and a high risk of infection.

You can do that yourself

Genital warts in the genital area are extremely unpleasant and stressful, but usually not dangerous. Nevertheless, a pure self-treatment should be refrained from and consulted a doctor immediately.

The human papillomaviruses (HPV) that cause the infection are highly contagious and are predominantly transmitted during sexual intercourse, although other modes of transmission are not excluded. The best self-help measure is to avoid the infection. The viruses invade the organism via tiny skin injuries.

Certain sexual practices, which are increasingly associated with small injuries of the mucous membranes, as is the case in particular with anal intercourse, are therefore particularly risky. For sexual intercourse condoms should therefore be used. Although these do not guarantee 100% protection, as even touching infected body parts may be enough to get infected. However, condoms considerably reduce the risk of infection.

Anyone who is affected by an acute genital warts infection may under no circumstances engage in sexual intercourse. In this situation, there must be no hygiene deficits, otherwise a lubrication infection threatens. In particular, no towels and no garments that rest directly on the skin should be shared. Laundry and other clothing that has had contact with infected body parts should be washed at least 60 degrees.

Strengthening the immune system with a healthy, vitamin-rich diet can also help to overcome an infection more quickly, or even prevent the disease from breaking out.

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