It is usually divided into two types: type ⅰ, characterized by isolated or multiple cauliflower or cockscomb-shaped processes, mostly in vulva, perianal and other parts; Type ⅱ, papillary, finger-like or papular lesions, mostly distributed in the inner labia minora, hymen ring, vestibule, navicular fossa and other mucosa.
Epidemiological data show that condyloma acuminatum is closely related to genital cancer. Human papillomavirus (HPV) was detected in different types of genital tumors by nucleic acid hybridization, and also in condyloma acuminatum. It is reported that 5% ~ 10% of condyloma acuminatum in vulva, cervix and perianal region can go through the late stage and develop into carcinoma in situ or invasive carcinoma after a period of time. It was also found that 15% penile cancer and 5% female vulvar cancer occurred on the basis of the original condyloma acuminatum, especially cervical cancer, and the malignant transformation was especially related to human papillomavirus-16, 18, 3 1 and 33 types. Huge condyloma acuminatum can be secondary to canceration. Many laboratory studies further show that there is a causal relationship between human papillomavirus, condyloma acuminatum and genital cancer. Condyloma acuminatum in vulva, penis or perianal region can be transformed into squamous cell carcinoma. This transformation usually takes 5-40 years. Therefore, after suffering from condyloma acuminatum, we must actively treat it and completely cure it. It is the best choice to find a specialist for treatment, otherwise improper treatment and stimulation will accelerate the malignant transformation.
Clinical manifestations of condyloma acuminatum
Clinical manifestations are varied. Lesions in low-temperature and dry parts of genitals are often small and flat, while those in warm and humid parts are often filiform or mastoid. At first, it was a reddish pimple, and then it grew up and merged with each other. The surface is uneven, moist and soft, in the form of papilloma, comb, grass, mushroom or vegetable, red or dirty gray, and the roots are often pedicled, which is easy to erode and bleed. Purulent secretions are often trapped in the cracks of skin lesions, and each scratch will cause stench, itching and secondary infection. Due to constant local humidity and chronic stimulation, it often grows rapidly. Some female patients even have a hairy spinous process or many cauliflower-like protrusions from vulva to vagina and cervix, like rose thorns or cockscomb flowers. The number of condyloma acuminatum ranges from a few to a dozen, dozens or even hundreds. A very small number of patients, due to untimely treatment, make the condyloma grow very big and become huge condyloma, which can go deep into the body and produce many fistulas leading to urethra, or turn into cancer after 5-40 years. Large condyloma in rectum can cause severe feeling after urgency. When the hormone level in the body changes dramatically during pregnancy, the genital blood supply is sufficient and the immune function of the body decreases, so the volume of genital warts increases rapidly, even to the extent of blocking the birth canal. When giving birth, warts often shed tears and bleed. Because of its fragile tissue, it will bring difficulties to suture and hemostasis. Some condyloma acuminatum can naturally shrink or even disappear at the end of pregnancy or after delivery. Generally, there are no obvious symptoms, but there is itching, dampness or friction. If there is a secondary infection, it may be accompanied by pain. When the vagina and cervix are damaged, it is manifested as increased vaginal discharge or bleeding after sexual intercourse. A huge rash can cause local foreign body sensation or pain caused by friction. Symptoms may worsen during sexual intercourse.
Some cases are subclinical infections or human papillomavirus carriers, and there are no clinical manifestations visible to the naked eye. After pregnant women suffer from condyloma acuminatum, they can transmit human papillomavirus to their babies during delivery, causing laryngeal warts and laryngeal papilloma. Even if the mother has no clinical symptoms after infection, the virus can be transmitted to the fetus through blood or placenta, so it is appropriate for women with this disease to have caesarean section during full-term pregnancy.
histopathology
Dyskeratosis, high hypertrophy of spinous layer, papillary hyperplasia, thickened and elongated epidermis, pseudoepithelioma-like appearance. Most mitotic images can be seen in the spinous cells in the basal layer, which look like cancer, but the cells are arranged regularly. The boundary between dermis and epidermis is clear, and there are vacuole cells in spinous layer. The cytoplasm of the cell is lightly stained, with a large and round nucleus in the center and deep basophils in the nucleus.
Dermal capillaries dilate, and dense chronic inflammatory cells infiltrate around the blood vessels.
diagnose
Condyloma acuminatum is often differentiated from genital cancer, condyloma plana, pseudo condyloma, genital bowenoid papulosis and pearl papulosis.
(1) The focus of genital cancer is hard and the boundary is unclear. Squamous epithelioma has obvious deep infiltration, often forming ulcers, and sometimes pathological examination is needed. Condyloma acuminatum is generally characterized by papillary growth, superficial lesions and little infiltration.
(2) Condyloma plana is a secondary syphilis rash. Verruca plana mostly occurs around anus and external genitalia, with wide base, no pedicle, flat appearance and moist and smooth wart surface. Treponema pallidum can be found by dark field microscopy, and syphilis serum reaction is positive. See the syphilis section for details.
(3) pseudo condyloma is also called the female villous labia minora. There are fish-like or tiny villous growths inside the adult female labia minora, which do not fuse with each other and remain unchanged for a long time, and the white acetate test is negative.
(4) Bowenoid papulosis is rare, which is mainly related to human papillomavirus 16 infection. It is characterized by multiple brown-red papules in genital area, with a diameter of 2 ~ 10 mm, which is very similar to condyloma acuminatum in clinic, but similar to Bowen's disease in histology. This diagnosis must be made by an expert.
(5) Pearl-like papulosis (pearl-like penile papulosis) occurs in the glans of men, and there are pearl-like papules with the same size and arranged neatly along the coronal groove of the glans. Grain size, dome, smooth, non-fusion, long-term unchanged.
(6) Ectopic sebaceous glands: papules have no overlapping growth in mucosa, and most of them are light yellow.
(7) Infectious soft wart: a single non-fused hemispherical papule with smooth periphery and a soft wart body extruded from the center.
(8) chancre: the skin damage of external genitalia is irregular ulcer with painful horizontal carbuncle. Ducrey can be detected in the exudate smear on the ulcer surface.
The diagnosis and differentiation of condyloma acuminatum mostly rely on the clinical experience of doctors, but because sexually transmitted diseases have been extinct in China for many years, clinicians have limited experience and it is inevitable to make misjudgments. It is reported that the misdiagnosis rate in some primary hospitals can reach 50-80%. Condyloma acuminatum is mostly located in the inner side of labia majora, vaginal opening and anus. The lesion is red, bright red or dark red verrucous hyperplasia with big rice grains or soybean grains. The wart body is moist and soft, and can coexist in one or more cases, sometimes showing typical plant-like lesions. Similar to condyloma acuminatum, there is pseudo condyloma or villous labia minora, the latter is more common in the inner and lower sides of labia minora, and the color of the spiny protrusion is similar to that of labia minora, which looks like velvet, but the patients are mostly asymptomatic, but the leucorrhea increases. Other diseases that are easy to be misdiagnosed are hymen vegetation, verruca plana (secondary syphilis rash) and sebaceous gland hyperplasia.
To accurately distinguish these different diseases, a very practical and simple method is the vinegar white test, that is, 5% glacial acetic acid solution is applied to the affected part, and after 3 minutes, the wart is white and condyloma acuminatum, otherwise it is another matter. Or wrap with gauze soaked in 3-5% glacial acetic acid solution for 3-5 minutes. If the affected area turns white, it means subclinical infection.
You can also do iodine yellow test, that is, 3 minutes after applying Lugo's solution, the yellow person can be diagnosed as condyloma acuminatum. Of course, a more reliable method is to do histopathological examination. In recent two years, there have been many reports about the differential diagnosis of pseudo condyloma in domestic magazines, especially the vinegar white test. However, the diagnosis of histopathological examination is not easy, and sometimes it is difficult to make a definite diagnosis, which still depends on the professional level and experience of the examiner. The definite diagnosis of this disease depends on the establishment of an effective virus culture system and the development of DNA probes with tissue immunochemistry and molecular bioengineering technology, so that pseudo condyloma will not be misdiagnosed as condyloma acuminatum.
Condyloma acuminatum occurring in vagina or cervix may be inconspicuous and varied. It may be misdiagnosed only by clinical examination, and cytology, colposcopy and histopathological examination are often needed.
A. Cytological examination: Pap staining of vaginal or cervical condyloma tissue smear, if mixed keratinocytes and vacuoles are found, is of diagnostic value for this disease.
B. Immunohistochemical examination: the peroxidase-anti-peroxidase antibody complex technique (PAP method) is an immunological method, which uses the antiserum of specific human papillomavirus to display the virus protein, thus proving that the virus antigen in condyloma acuminatum is faster and more effective than the conventional electron microscope method.
Pathological examination is helpful for diagnosis, and the upper vacuole cells in spinous cells are the most diagnostic.
Molecular biological techniques such as polymerase chain reaction (PCR) are used to detect human papillomavirus, and this method can also be used to determine subtypes. However, PCR experiments in most medical institutions in China are not enough as a diagnostic tool because of insufficient conditions and too many misdiagnosis phenomena. At present, gopla is trying to diagnose condyloma acuminatum with gene chip technology, but it is only suitable for laboratory research and difficult to popularize in recent years because of its high cost and dependence on PCR amplification results.
treat cordially
At present, the treatment of condyloma acuminatum is mainly external treatment, supplemented by internal treatment. There are many external treatments, including drug therapy, cryotherapy, laser therapy, microwave therapy, electrocautery therapy, surgery and so on. Drug treatment is convenient and easy to operate, but it usually needs to be repeated several times. Some drugs such as trichloroacetic acid may burn the mucosa.
First, medication. In order to reduce losses.
(1) 5% 5-Fu Ointment 5-Fu is a commonly used anti-tumor drug, which can inhibit cell proliferation with light intensity and generally needs treatment for 2 ~ 3 weeks.
(2) wart enemy: drop 0.5% wart enemy solution on the wart with a single-hole or porous plastic rod, so that the liquid medicine can slowly penetrate into the wart base. Warts will turn purple after being coated with medicine and can be dried by themselves. Be careful not to use too much medicine, so as to avoid the liquid medicine flowing to normal tissues. Wash it off with clean water after 4 hours.
(3) Acetic acid: Trichloroacetic acid is a strong acid, which can be used to burn warts and is generally used to treat type II lesions. Before smearing, dip a cotton ball in 2% caine and smear the affected area for 3-5 minutes, and then dip a cotton swab in 50% trichloroacetic acid to make the liquid medicine reach the base. Be careful not to hurt the surrounding healthy mucosal tissue when taking the medicine, and do not use it during menstruation; Take the medicine twice a week. Or use 20% salicylic acid glacial acetic acid for external application.
(4) 1-3% peptide butylamine cream for external use, twice a day, has no toxic and side effects, and can be used for condyloma acuminatum in vagina. Or wash the affected area with 1: 5000 potassium permanganate first, then apply a thick layer of ointment and wrap it with gauze, and change the medicine once a day. Four weeks is a course of treatment. Mild intensity, no toxic or side effects have been found at present, and long-term treatment is needed.
(5) Otoxin (podophyllotoxin solution) is a new and efficient drug for the treatment of condyloma acuminatum, with no irritation, for external use, 1 time, 3 ~ 5 days a day.
(6) Apply 20-25% podophyllotoxin tincture (or 0.5% podophyllotoxin solution) or liquid paraffin preparation directly to the lesion. Or 20-25% podophyllum grease is dissolved in benzoic acid tincture or mineral oil, and applied locally. Use 1 ~ 2 times a week, and scar can be removed in less than 6 weeks. Because of its toxicity, the dosage should be limited to less than 0.5ml each time, and the application area should not exceed 10cm2. After applying the medicine 1-4 hours, the local area should be cleaned. This medicine has side effects, such as erythema, erosion and burning pain, which can cause ulcer and necrosis in severe cases. Pay attention to protect the surrounding skin mucosa, wash it off with soap after the first application for 2-4 hours, and wash it off after repeated application for 6-8 hours to avoid burning the skin. It has teratogenic effect and is prohibited for pregnant women. Pay attention to protect the surrounding normal skin when taking medicine, and apply vaseline on the normal skin as a preventive measure in advance. This method is more painful after use and often requires painkillers. Can cause systemic toxic reaction, dizziness, lethargy, coma, vomiting, etc. And taking too much is dangerous, which may cause recurrent neuritis, paresthesia, fever, leukopenia and thrombocytopenia, coma and even death. Pregnant women are not allowed to use it.
(7) Apply the mixture of Orthophoto-mycin and Pingyangmycin with normal saline to the affected area, 2-3 times a week.
(8) Acyclic guanosine ointment
(9) Keep the affected area clean and dry, and clean it with 3% hydrogen peroxide solution or 1: 5000 potassium permanganate solution.
(10) 1-5% fluorouracil cream or 2% fluorouracil solution is applied externally, once a day 1 time, and only a few lesions are applied each time, so as to avoid erosion reaction of scrotum and mucosa.
(1 1)0.25% herpes cream twice a day. Two weeks in a row is a course of treatment.
(12) gram wart. At present, it is a good external medicine. Low toxicity, thorough treatment and few scars. (anzhen hospital Urology Department can be consulted) Follow-up for 3 months after cure to prevent recurrence.
The application of (12) 1% butylamine ointment, three times a day for six weeks, is expected to be cured.
Second, microwave therapy. This is a treatment method that rose after entering the 1990s. Its principle is to use the high-frequency vibration of microwave to evaporate the water inside the wart. The characteristic of microwave therapy is that the wart is completely destroyed and it is not easy to recur, but the wound surface recovers slowly and is easy to be infected. Therefore, microwave therapy is especially suitable for the treatment of condyloma acuminatum with large wart and isolated dispersion, and it should be kept away from the foreskin frenum to prevent it from damaging the foreskin frenum and affecting male sexual function.
3. Cryotherapy: Cryotherapy with liquid nitrogen or carbon dioxide dry ice will cause the wart tissue (that is, the damaged part of the skin) to be necrotic. Condyloma acuminatum is caused by condyloma acuminatum virus infection, which leads to benign hyperplasia of skin mucosa. It has a large number of small blood vessels and proliferates rapidly. By freezing, condyloma acuminatum can be frozen to form local high edema, thus destroying the wart body. The biggest advantage of cryotherapy is that it leaves no trace locally, and the cure rate is about 70%. In the course of treatment, there is generally no obvious sequelae except local redness, pain and blister reaction. Spray method or direct contact method can be used, which is suitable for verruca plana and verruca minor. Generally, it is frozen once a week 1 time, 2 ~ 3 times in a row. General post-menstrual treatment.
Fourth, laser treatment: suitable for superficial condyloma such as vulva and anus; It is characterized by quick response, and the wart can fall off during treatment. Commonly used is carbon dioxide laser, which cauterizes warts. Generally, 1 time can make warts fall off. However, because the laser beam is too concentrated, laser treatment is only suitable for condyloma acuminatum with small warts. If the wart is large, laser treatment is easy to recur. The cure rate can reach 80%.
Five, electrocautery treatment: electrocautery is an ancient treatment. In the past, dermatologists often used high-frequency electrotome or soldering iron to burn warts, pigmented nevus and other skin vegetation. Its characteristics are simple operation and quick response. High-frequency electrotome can directly remove and dry wart, and the treatment is thorough, but the healing of sore surface by electrocautery is slow. To sum up, electrocautery can be used for the treatment of any condyloma acuminatum, but it has high technical requirements for the performer, and it is harmful to burn too much or not. At the same time, attention should be paid to aseptic operation to prevent infection. High-frequency electrotome or electroacupuncture is more suitable for the treatment of tiny lesions of cervix or vagina. Larger warts require batch electrocautery.
Surgical excision: surgical excision can be considered for large isolated pedicled warts. Surgical resection of condyloma acuminatum is generally not recommended, because condyloma acuminatum is easy to relapse after surgical treatment, which makes the treatment fail. However, for large pedicled warts or warts suspected of malignant transformation, surgical resection can be considered. Some patients with condyloma acuminatum grow too fast or are as big as cauliflower, and other treatments are very difficult, so surgery can be considered. In order to prevent recurrence, other treatments were given after operation. According to the size and coverage area of wart, focus resection or vulvar resection is selected.
Seven, surgical curettage: during treatment, the left hand will tighten the skin or mucosa of the lesion, or hold a disinfection curette to scrape off the lesion tissue from the root; Thoroughly remove the pathological tissue left in the wound, and then apply it locally with 33% trichloroacetic acid solution or pure carbonic acid solution or 3% ferric chloride solution.
Eight, surgical ligation: suitable for a single small lesion with bangs, after local disinfection and local anesthesia; Lift the wart tissue with tweezers, clamp the root with hemostatic forceps, and then tie the base with 1 silk thread. Generally, warts can fall off 3-5 days after ligation.
Interferon: intramuscular injection 1 10,000 unit days, continuous treatment 10- 14 days, and then injection 3 times a week for about 4 weeks. 2. Local injection: Interferon is injected directly into the base of the lesion twice a week.
Polymorphonuclear cells (inducer): 20mg intramuscular injection once, twice a week. 2-4 weeks is a course of treatment.
They have their own indications, and the cure rate is between 50% and 80%. Follow the doctor's advice.
Condyloma acuminatum generally does not need oral treatment. However, some patients have a certain degree of immune deficiency, and repeated application of various external treatments has failed. At this time, we can combine certain internal treatment methods to achieve the goal of treating both internal and external problems.
Oral treatment of condyloma acuminatum is mainly to improve immunity and antivirus. Generally, western medicine can give 2mL of polymyocyte injection, intramuscular injection, 1 time, once every other day. Or interferon1~ 3 million units, intramuscular injection, three times a week. The former can induce the body to produce interferon, while interferon has antiviral and antiproliferative effects. Gopla found that the side effects of interferon α-2b were relatively small and the curative effect was good. According to other experts' research reports, the adverse reaction of IFN-β in treating condyloma acuminatum is lighter than other types of interferon. Initiated by Shenyang Sansheng, interferon is now playing a price war, and the price has dropped by more than 50%, so its application will become more and more popular.
Traditional physical therapy methods, such as freezing, laser, electrocautery, surgery, etc. Only the superficial tissue of wart can be destroyed, and additional antiviral treatment must be carried out after operation. Patients suffer a lot, the treatment time is long, the cost is expensive, and because of the decline of human immunity, it is easy to relapse. The data show that 47.5% of patients will relapse after seven days if they are treated by laser alone, which will affect the normal life of both husband and wife after recovery and bring long-term mental pain to patients. Triacetic acid, or other corrosive compounds, aims to eliminate warts by simple corrosion. Although the effect is quick and the price is low, it can eliminate warts in a short time like physical therapy, but it is easy to treat the symptoms rather than the root cause.
Traditional Chinese medicine treatment is mainly based on syndrome differentiation. According to the constitution of different patients, drugs for clearing away heat and toxic materials, eliminating dampness and removing warts are given for treatment.
According to the theory of traditional Chinese medicine, condyloma acuminatum is mainly caused by damp-heat accumulation. Not only do we realize the infectivity of condyloma acuminatum, but we also realize the physique of patients with condyloma acuminatum. Only when internal and external factors interact can we get sick. (1) damp heat constitution likes fat, sweet and thick taste, alcohol and tobacco, and damp heat accumulates in the skin and mucous membrane, which makes the front and back yin moist locally, which is toxic for a long time and produces condyloma acuminatum. (2) Exogenous toxic pathogens are mostly due to unclean sexual intercourse and infection with damp and turbid toxic pathogens, which is condyloma acuminatum.
Traditional Chinese medicine is often divided into three treatment methods according to the patient's constitution and the size of wart, combined with systemic symptoms. They are damp-heat downward flow syndrome, exogenous toxic evil syndrome and qi stagnation and blood stasis syndrome. Damp-heat syndrome often occurs in patients with vegetarian obesity and wet genitals; Exogenous poison syndrome mostly occurs in patients with unclean sexual intercourse; Blood stasis syndrome is mainly seen in patients with long-term condyloma acuminatum and gloomy wart body.
Damp-heat syndrome may have perianal skin lesions, moist and ruddy skin, too long foreskin, excessive leucorrhea or other skin diseases. Often accompanied by bitter taste, sticky mouth, thirst, sticky stool and yellow urine. The tongue is red and greasy with yellow fur, and the pulse is thin. This is due to damp-heat pouring into the liver and gallbladder and vaginal flow along the meridian. The prescription for treating damp-heat is as follows: Rhizoma Atractylodis 10g Cortex Phellodendri 10g raw Coicis Semen 30g Rhizoma Smilacis Glabrae 30g Cortex Moutan 10g medulla tetrapanacis 10g Alismatis Rhizoma 10g Portulaca oleracea 30g. Rhizoma Atractylodis and Cortex Phellodendri in the prescription can clear damp-heat in lower energizer; Raw coix seed strengthens the spleen and eliminates dampness, which has antiviral effect; Rhizoma Smilacis Glabrae, Cortex Moutan, medulla Tetrapanacis, Rhizoma Alismatis and Herba Portulacae are used to detoxify and remove dampness, promote blood circulation and remove blood stasis. For severe damp-heat, Gentiana scabra10g; Can be added; Aloe vera 10g can be added for constipation.
The common wart of exogenous toxic syndrome increases rapidly, or it is complicated with syphilis and gonorrhea, and there is a clear history of unclean sexual intercourse. Self-conscious symptoms are often mild or absent, and the tongue pulse can be normal. This is due to exogenous toxic evil and stagnation of toxic gas, so the wart body increases rapidly. To clear away heat and toxic materials, the commonly used prescription is Quyou No.3: purslane 60g Patrinia herb 15g Lithospermum 15g Folium Isatidis 15g equisetum 15g. Purslane is the main medicine in the prescription, clearing away heat and toxic materials; With Patrinia scabra, Lithospermum, Folium Isatidis and Equisetum Equisetum, the effects of clearing away heat and toxic materials, promoting blood circulation and resolving hard mass can be enhanced. If the lesion is dark or the course of disease is long, products for promoting blood circulation and removing blood stasis such as honeycomb, salvia miltiorrhiza and safflower can be added.
Patients with blood stasis syndrome can see dark red or dark brown lesions, slow growth, persistent or painful. The tongue is pale, the coating is thin and white, and the pulse is thin and astringent. This is due to the long-term accumulation of toxic pathogens, which blocks qi movement and causes qi stagnation and blood stasis. Treatment should be based on regulating qi and promoting blood circulation, removing blood stasis and resolving hard mass. The commonly used prescription is Taohong Siwu decoction: peach kernel 10g safflower 10g chuanxiong rhizome 10g angelica sinensis 10g salvia miltiorrhiza 10g beehive 10g Bupleurum chinense 10g selfheal 30g. The drugs for promoting blood circulation and removing blood stasis are peach kernel, safflower, Ligusticum chuanxiong, angelica, salvia miltiorrhiza and nidus vespae. Bupleurum soothes the liver and regulates qi, and leads drugs to the disease site; Prunella vulgaris clearing away heat and toxic materials, softening and resolving hard mass. If the patient is suffering from qi deficiency, 30 grams of Radix Astragali can be added to invigorate qi and detoxify and improve the immunity of the body; If the wart is hard, 30 grams of raw keel and 30 grams of raw keel can be added to soften and disperse the knot.
Traditional Chinese medicine has found many effective external washing prescriptions and some effective Chinese medicine preparations in long-term practice. The following are some effective Chinese medicine prescriptions:
(1) Purslane 60g, dried alum 30g, mirabilite 100g smoked and washed for external use. Decocting water for fumigation and washing, 1 ~ 2 times, daily 1 time, 20 minutes each time. After fumigation and washing, mix indigo naturalis powder with Liuyi powder, smear it on wart and keep it dry and clean.
(2) Brucea javanica oil graffiti Brucea javanica oil is a commonly used Chinese herbal medicine. Brucea javanica oil can be obtained by mashing. Has the effects of clearing away heat and toxic materials and removing warts. If the wart is small, apply it to the affected area, or soak it in 1 part brucea javanica and 3 parts peanut oil for half a month and then apply it to the affected area.
(3) External crystal cream is a traditional external medicine of Chinese medicine. It is a plaster made of quicklime and glutinous rice, which can burn warts. Crystal cream can be directly applied to the affected area,/kloc-0 times a day for 3 ~ 5 days.
(4) Decoct 200g of Equisetum Ointment with water, filter out the liquid medicine, heat and concentrate into paste, soak the gauze strip in the liquid medicine for 2 days, take it out and apply it to the affected part, three times a day. Modern research has proved that Equisetum equisetum has good antiviral effect and has been widely used to treat verruca plana, verruca vulgaris and condyloma acuminatum. China Journal of Integrated Traditional Chinese and Western Medicine1993; 13(6)∶334 〕。
(5) Alumen, Cortex Dictamni, Scutellariae Radix and Radix Isatidis each 30g, Fructus Cnidii, Fructus Zanthoxyli, Fructus Kochiae and Flos Hibisci 65438 05g, covered with medical gauze, boiled in water to 2000ml, filtered, cooled to 40℃ and sat in the bath. This prescription is suitable for women with condyloma acuminatum or men with large-scale condyloma acuminatum [Wang Xingzhou. China Journal of Integrated Traditional Chinese and Western Medicine1993; 13(5)∶280〕。
(6) The formula of the compound powder cream consists of 6 grams of powder cream, calomelas, Cortex Phellodendri and Radix Glycyrrhizae, 9 grams of Lithargyrum and Laohuangdan, and 5 grams of borneol. Grind into fine powder, mix it with vaseline into 25% ointment, and apply it to the affected area [Chen Cigen. Journal of traditional chinese medicine, Zhejiang1994; 29( 7)∶30 1〕。
(7) 30g of pepper, 5g of mint water and 20g of gallnut are ground into fine powder and sieved with a 100 mesh sieve for later use. When in use, apply a small amount of powder to the affected part and rub it with your hands for a while. Some parts feel numb and tingling, and the degree varies from person to person. Generally lasts 15 ~ 60 minutes, and the medicine is used several times a day [Zhang Shuwen. Chinese journal of dermatovenereology1993; 7(2)∶ 12 1〕。
(8) Youling liniment is 250g each of Radix Isatidis, Radix Sophorae Flavescentis, Rhizoma Cyperi, Equisetum equisetum and Nivespae, and 500ml of aged vinegar. Usage: put the medicine into a container, add 5000mL of water, boil for 65438 0 hours, remove residue and filter to get 2000mL clear liquid, and add aged vinegar to get the finished product. Sub-packaging, 50 ml per bottle, sealed from light; When in use, dry the wart body and normal skin around it with a cotton swab, disinfect it with 0. 1% bromogeramine solution, and then apply the liquid medicine on the wart body to dry. Three times a day, 2 weeks 1 course of treatment [Wang Bingyan]. Jiangsu Traditional Chinese Medicine1991; (2)∶22〕。
(9) Xiaoliu Pill, 3-6g each time, 2-3 times a day, taken with warm water.
In the books of traditional Chinese medicine, there are many therapeutic prescriptions that are helpful to the rehabilitation of condyloma acuminatum. They have the same characteristics of clearing away heat and toxic materials, eliminating dampness and removing warts.
(1) Hedyotis diffusa Drink (Dictionary of Traditional Chinese Medicine): decoct 30 ~ 60g of Hedyotis diffusa in water to get juice, remove residue, add proper amount of honey and drink it regularly. Indications: Condyloma acuminatum belongs to heat toxicity according to TCM syndrome differentiation.
(2) Take 500 grams of Smilax China (Dictionary of Traditional Chinese Medicine) and 25 grams of Glycyrrhiza uralensis Fisch, add water and decoct twice, combine the filtrates, and then concentrate to 65438 000 ml with slow fire, 50 ml each time, twice a day. Indications Condyloma Acuminatum belongs to heat toxicity according to TCM syndrome differentiation.
(3) 250g of Portulaca oleracea and 0/50g of flour/kloc-were made into steamed bread and eaten separately.
Family self-treatment:
1. Usage: ① 40g of ochre, 5g of dried alum and 5g of borneol. * * * Grind into fine powder and apply it to the affected area twice a day until it is cured. ② Talc 30g, licorice 5g, dried alum powder 12g. * * * Grind into fine powder, smoke and wash, then spread it on the wart and keep it dry.
2. Fumigation and washing: ① 60 grams of purslane, 30 grams of folium Isatidis, 20 grams of alum and 20 grams of cortex moutan are decocted, smoked first and then washed, twice a day. ② Coicis Semen, Folium Isatidis, Radix Isatidis and Concha Ostreae 30g, Herba Patriniae, Prunellae Spica and Radix Paeoniae Rubra 15g. Decoct with water, smoke first and then wash, each time 15 ~ 20 minutes, twice a day.
1/3 patients with condyloma acuminatum are accompanied by one or more sexually transmitted diseases, such as gonorrhea, trichomoniasis, syphilis and chlamydia infection. Therefore, even if there are no symptoms, routine examination should be carried out. Patients who have been cured should still be carefully examined regularly to prevent recurrence. Recurrent condyloma acuminatum should pay attention to whether it is cancerous or not, and the results of histopathological examination are needed.
Keep the susceptible parts dry and clean.
Attached Figure: Female Condyloma Acuminatum || Condyloma Acuminatum of glans penis
Attachment: Papers and treatment plans on condyloma acuminatum || English version of condyloma acuminatum
The following are the therapeutic drugs approved by some countries (for reference, listing here does not mean that I recommend them, and all drugs should be selected under the guidance of doctors in regular hospitals):
Youbijing: Tincture, with Chinese medicine as the main raw material, Xiantao Kang Hua Health Products Co., Ltd., with a monthly production capacity of 200,000 bottles. The effective rate of all kinds of condyloma acuminatum reaches 100% (I just don't believe it after reading its publicity materials). The method of "transdermal drug delivery" can make the drug penetrate the epidermis, first stop the virus from replicating or killing the virus, and then the killed virus and damaged wart tissue will fall off with the epidermis peeling off, thus achieving the goal of treating both the symptoms and root causes. Does not contain any corrosive compounds such as strong acid and alkali, and has the characteristics of completely killing viruses, quickly removing warts in 3-4 days, leaving no scars, safe and simple use and no recurrence. Generally, this product only needs to be applied once a day, and the cost is low.
In the process of consultation, the article "Condyloma Acuminatum" is constantly improved according to the problems. But some problems are not easy to integrate and there are a lot of problems at the same time, so I included some classic questions and answers in the consultation question and answer. Be careful not to take medicine by yourself. Please follow the doctor's advice.
References:
Condyloma acuminatum of female vulva
Condyloma acuminatum is mainly a benign wart caused by human papillomavirus (HPV) type 6 and 1 1 infection. It is mostly transmitted through sexual contact, and sexual partners often suffer from condyloma acuminatum at the same time. The peak age of onset is 20 ~ 30 years old. A few cases can also be cross-infected by other means, occasionally occurring in infants and pre-adolescent children exposed to infection. The most common parts are labia minora, clitoris, around hymen, external urethral orifice, vaginal wall and cervix. Perianal and perineum can also be involved. The incubation period can be as long as several months. There is often local itching.
Visually, typical cases present multiple small and pointed nipples, which are reddish or gray and moist. Some can also be patchy or fused into tuberous cauliflower. Microscopically, epithelial hyperplasia is a papillary structure, typically a slender pointed nipple covered with squamous epithelium, with incomplete keratinization and slight hyperkeratinization. Spine cells proliferate obviously, accompanied by thickening and lengthening of epithelial nail process. In the spinous cell layer, there are many different kinds of vacuole cells in the upper part, with large nuclei and different sizes, thick chromatin and deep staining, empty halos around the nuclei, and cytoplasmic filaments can be seen in the empty halos (figure 13- 1). Nuclear virus particles can often be detected under electron microscope. At present, the core-shell antigen of human papillomavirus is detected by immunohistochemistry, and the DNA of human papillomavirus is detected by in situ hybridization. Positive results are helpful for diagnosis.
Epithelial hyperplasia is slender, pointed and papillary, epidermal keratinization is incomplete, spinous cells proliferate, and there are many vacuolar cells in the middle surface.
The clinical course of the disease is generally slow and long, and the lesions during pregnancy develop rapidly. After delivery, it can be degenerative, and it can also be recurrent. Treatment methods include drugs, electrocautery, freezing and laser therapy.
Recently, some authors have suggested that the incidence of complications between this disease and vulvar cancer is high, and there are few reports of malignant transformation into carcinoma in situ, verrucous carcinoma or well-differentiated squamous cell carcinoma.
What are the two disciplines of administrative management?
There are no two disciplines under administration, and they are two disciplines in themselves.