genital warts

HUMAN PAPILLOMAVIRUS
The human papillornavirus (HPV), also known as genital warts, has more than 100 strains, some of which are harmless; others are transmitted through sexual contact. Genital warts are most often caused by subtypes six or 11 of HPV. Other high-risk HPV subtypes are associated with cervical cancer. They typically present as multiple lesions on the external genitalia, including the vulva, penis, perineum, perianal skin, or scrotum. Occasionally, there may only be a solitary lesion present. They can also occur internally on the mucous membranes of the vagina, anus, urethra, cervix, or mouth. The appearance of genital warts ranges from flesh-colored, cauliflower-like lesions to red or brown dome-shaped, smooth lesions.

Symptoms
Most patients do not experience any symptoms. Occasionally, men or women with external genital warts may experience itching. When internal warts are present, they typically do not cause symptoms unless they are large. Symptoms of internal warts in women include vaginal pain, vaginal bleeding, and pain with intercourse.

Diagnosis
Diagnosis is usually made based on the appearance of the lesions. A biopsy may be performed if there is a question regarding the diagnosis, or if there is a poor response to therapy.

Treatment
Treatment of genital warts is based on the location, number, and size of the lesions. Treatment response rate for genital warts in men and women ranges from 40 to 90 percent. depending on the type of therapy used.

Treatment options for women include:
• cryotherapy with liquid nitrogen,
• imiquimod topical therapy,
• interferon,
• trichioroacetic acid,
• podophyllin,
• podofilox,
• surgical removal, and
• laser therapy.
If there is no response to medical therapy after three cycles, the diagnosis should be confirmed with biopsy and the treatment changed.

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5. STD Genital Warts A sexually transmitted disease (STD) is a disease caused by a pathogen(i.e., a disease-causing virus, bacterium, parasite, fungus) that isspread from person to person primarily through sexual contact. STDs canbe painful, irritating, debilitating, and life threatening. STDs occur most commonly in sexually active teenagers and young adults,especially those with multiple sex partners. An estimated 200 to 400million people worldwide are affected¡ªrepresenting men and women ofall economic classes, including about 70 million in the United States.Generally, STD incidence has declined in the United States over thepast 15 years, although rates among certain populations, including menwho have sex with men, have increased. Most STDs cause relatively harmless disease, producing few symptoms orno symptoms. However, some produce persistent asymptomatic or minimallysymptomatic disease (e.g., chlamydia). Some people carry the diseasefor days or weeks, while others carry the disease for longer periods,even for life. During this time, an infected individual, or carrier,can spread disease. In persistent infection, the pathogen evades detection by the immunesystem and remains fairly inactive, causing no overt disease. Thisinactivity is called latency. However, certain triggers (e.g., stress,immune suppression, injury) can reactivate latent pathogens. In somecases, reactivated disease is asymptomatic (e.g., chlamydia); inothers, overt (e.g., genital herpes); and in still others, severe andeven fatal (e.g., HIV/AIDS). Complications of STD infection include pelvic inflammatory disease(PID) and cervicitis (inflammation of the cervix) in women, urethritis(inflammation of the urethra) and prostatitis (inflammation of theprostate) in men, and fertility and reproductive system problems inboth sexes. Possible consequences to a child infected by his or her mother, whilein the womb or during birth, include stillbirth, blindness, andpermanent neurological damage, depending on the disease. A person infected with an STD is more likely to become infected withHIV, and a person infected with HIV and another STD is more likely totransmit HIV. Viral STDs, such as genital herpes (HSV) and human immunodeficiencyvirus (HIV), cannot be cured, but symptoms can be managed withmedication. Bacterial STDs, such as gonorrhea and chlamydia, can becured with antibiotics. Fungal (e.g., vaginal yeast infection) andparasitic (e.g., trichomoniasis) diseases can be cured with antifungaland antihelminthic agents, respectively. Early diagnosis and treatmentincrease the chances for cure. The only sure way to avoid becoming infected with an STD is monogamywith an uninfected partner. It is important for partners to discusstheir sexual and STD history before having sex. Prevention is possibleonly if sexually active individuals understand STDs and how they arespread. The risk for transmission is dramatically reduced with the use ofcondoms. The following behaviors and conditions can increase the riskfor STDs:...

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