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GYNCOLOGICAL STDs Part 02

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Condylomata Acuminata (see Colour Atlas D7)

 

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  • Human papillomavirus (HPV)

 

Clinical presentation

  1. latent infection
    • no visible lesions
    • detected by DNA hybridization tests
    • asymptomatic
  2. subclinical infection
    • visible lesion only after 5% acetic acid applied and magnified
  3. clinical infection
    • visible  wartlike lesion without magnification
    • hyperkeratotic, verrucous or flat, macular lesions vulvar edema
  • lesions tend to get larger during pregnancy
  • > 60 subtypes of which > 20 are genital subtypes
  • classified according to risk of neoplasia and cancer
  • types 16, 18, 45, 36 (and others) associated with increased incidence of cervical and vulvar intraepithelial hyperplasia and carcinoma

 

Diagnosis

  1. cytology (Pap smear)
  2. koilocytosis = nuclear enlargement and atypia with
    perinuclear halo
  3. biopsy of visible and acetowhite lesions at colposcopy
  4. detection of HPV DNA using nucleic acid probes not routinely done

 

Treatment (see Gynecological Oncology Section)

  1. chemical : trichloroacetic acid (podophyllin, 5-FU)
  2. physical: cautery, cryotherapy, laser
  3. condyloma should be treated early during pregnancy if not successful then C-section should be considered
  4. cannot be prevented by using condoms


Molluscum Contangiosum

 

  1. epithelial proliferation caused by a growth-stimulating poxvirus (Molluscipoxvirus)image
  2. mildly contagious

 

Symptoms

  • occasionally mild pruritis

 

Clinical presentation

  1. multiple nodules up to 1 cm diameter on vulva and
    perineum with umbilicated center

 

Treatment

  1. chemical  :  carbonic acid, TCA, or silver nitrate
  2. physical   :  curette

GYNCOLOGICAL STDs Part 02 GYNCOLOGICAL STDs Part 02 Reviewed by Radiology Madeeasy on August 24, 2010 Rating: 5
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