Human papillomavirus: Difference between revisions

 
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==Background==
==Background==
{{Skin anatomy background images}}
*Abbreviation: HPV
*Abbreviation: HPV
*Most common [[STI]] in US.
*Most common [[STI]] in US.
*Associated with cervical, vulvar, penile, anal cancer, oropharyngeal cancer.
*Over 200 HPV types, with 40 that infect the genital mucosa <ref> Cdc.gov. (2018). Surveillance Manual | HPV | Vaccine Preventable Diseases | CDC. [online] Available at: https://www.cdc.gov/vaccines/pubs/surv-manual/chpt05-hpv.html [Accessed 3 May 2018]. </ref>
*Vaccine available for adolescents 11 and older, and immunocompromised patients
*Associated with cervical, vulvar, penile, anal and oropharyngeal cancer.
*Vaccine available for adolescents 11 and older, and immunocompromised patients.
 
===HPV Types and Associated Disease Entities===
{| class="wikitable" style="margin:1em;"
|-
! Disease
! HPV type
|-
| Common [[wart]]s
| 2, 7, 22
|-
| [[Plantar wart]]s
| 1, 2, 4, 63
|-
| Verruca plana (flat)
| 3, 10, 28
|-
| [[Condyloma acuminata]] (anogenital)
| 6, 11, 42, 44 and others
|-
| Anal dysplasia (lesions)
| 6, 16, 18, 31, 53, 58
|-
| Genital cancers
|
*Highest risk: 16, 18, 31, 45
*Other high-risk: 33, 35, 39, 51, 52, 56, 58, 59
*Probably high-risk: 26, 53, 66, 68, 73, 82
|-
| Epidermodysplasia verruciformis
| more than 15 types
|-
| Focal epithelial hyperplasia (mouth)
| 13, 32
|-
| Mouth papillomas
| 6, 7, 11, 16, 32
|-
| Oropharyngeal cancer
| 16
|-
| Verrucous cyst
| 60
|-
| Laryngeal papillomatosis
| 6, 11
|}


==Clinical Features==
==Clinical Features==
[[File:Dornwarzen.jpg|thumb|Warts on toe.]]
[[File:Largeplanterwart.jpg|thumb|Plantar wart on sole of foot.]]
*Most infections asymptomatic
*Most infections asymptomatic
*Anogenital warts (Condyloma acuminata)
*Anogenital warts ([[Condyloma acuminata]])
**painless flesh-colored papules or cauliflower-like projections
**painless flesh-colored papules or cauliflower-like projections
**Contagious via skin contact
**Contagious via skin contact
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==Differential Diagnosis==
==Differential Diagnosis==
{{STD DDX}}


==Diagnosis==
==Evaluation==
*Clinical dx
*Clinical diagnosis
*Pap smear for cervical lesions
*Pap smear for cervical lesions


==Management==
==Management==
*Safe-sex counseling
*Safe-sex counseling (HPV-2)
*For genital warts can use:
**Podofilox
**Imiquimod
**Cryotherapy
**Trichloroacetic acid
**Surgical removal


==Disposition==
==Disposition==
Outpatient f/u
*Outpatient follow up


==See Also==
==See Also==
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==External Links==
==External Links==
*http://www.cdc.gov/std/hpv/stdfact-hpv.htm


==References==
==References==
1. [http://www.cdc.gov/std/hpv/stdfact-hpv.htm CDC: HPV]
<references/>
<references/>
[[Category:ID]]
[[Category:Dermatology]]
[[Category:OBGYN]]
[[Category:Urology]]

Latest revision as of 16:26, 11 December 2024

Background

Normal dermal anatomy.
  • Abbreviation: HPV
  • Most common STI in US.
  • Over 200 HPV types, with 40 that infect the genital mucosa [1]
  • Associated with cervical, vulvar, penile, anal and oropharyngeal cancer.
  • Vaccine available for adolescents 11 and older, and immunocompromised patients.

HPV Types and Associated Disease Entities

Disease HPV type
Common warts 2, 7, 22
Plantar warts 1, 2, 4, 63
Verruca plana (flat) 3, 10, 28
Condyloma acuminata (anogenital) 6, 11, 42, 44 and others
Anal dysplasia (lesions) 6, 16, 18, 31, 53, 58
Genital cancers
  • Highest risk: 16, 18, 31, 45
  • Other high-risk: 33, 35, 39, 51, 52, 56, 58, 59
  • Probably high-risk: 26, 53, 66, 68, 73, 82
Epidermodysplasia verruciformis more than 15 types
Focal epithelial hyperplasia (mouth) 13, 32
Mouth papillomas 6, 7, 11, 16, 32
Oropharyngeal cancer 16
Verrucous cyst 60
Laryngeal papillomatosis 6, 11

Clinical Features

Warts on toe.
Plantar wart on sole of foot.
  • Most infections asymptomatic
  • Anogenital warts (Condyloma acuminata)
    • painless flesh-colored papules or cauliflower-like projections
    • Contagious via skin contact
  • Cervical cancer

Differential Diagnosis

Sexually transmitted diseases

Evaluation

  • Clinical diagnosis
  • Pap smear for cervical lesions

Management

  • Safe-sex counseling (HPV-2)
  • For genital warts can use:
    • Podofilox
    • Imiquimod
    • Cryotherapy
    • Trichloroacetic acid
    • Surgical removal

Disposition

  • Outpatient follow up

See Also

External Links

References

  1. Cdc.gov. (2018). Surveillance Manual | HPV | Vaccine Preventable Diseases | CDC. [online] Available at: https://www.cdc.gov/vaccines/pubs/surv-manual/chpt05-hpv.html [Accessed 3 May 2018].