Vulvar Squamous Epithelial Verrucous Hyperplasia

Introduction Vulvar squamous epithelial hyperplasia is common in condyloma acuminata. Condyloma acuminata is also called genus genital warts, genital warts, sharp warts, and sexually transmitted diseases. It is an epidermoid hyperplasia caused by infection with human papillomavirus (HPV). 60% of patients with condyloma acuminata are infected by sexual contact. One of the family members is infected from the society, and the spouse is transmitted through sexual life. It is also possible to pass on to other people in the family through close contact with the family. This brings about physical pain, family disharmony, and mental stress. Therefore, improving sexual ethics and not taking extramarital sex is an important aspect to prevent the occurrence of genital warts.

Cause

Causes of vulvar squamous epithelial hyperplasia:

First, Chinese medicine:

Chinese medicine believes that the main cause of condyloma acuminata is due to uncleanness or contact with dirty items. The hot and humid sinister poisons the vulva skin and mucous membranes from the outside, resulting in liver stagnation, qi and blood, and dampness and heat. wart. Because the wet poison is yin and evil, its sexuality is sticky, it is difficult to get rid of it, and it is easy to burn righteousness. It is a sinister evil, so that genital warts are easy to relapse and difficult to cure.

(1) Unclean sex: Male and female extramarital sex or sexual promiscuity or multiple sexual partners are the main causes of genital warts. Because of the unclean sex life, it is easy to feel the evil of dampness and heat. The disease is invaded by the mucous membrane of the vulva and the skin, causing the dampness and heat of the liver to be blocked, and the blood and blood are not harmonious. The damp heat and evil spirits gather in the vulva skin to become a cockroach.

(2) Indirect contact with contaminated items: Condyloma acuminata may also be infected by contact with the contaminated items of the vulva skin and mucous membranes. For example, bath towels, bathtubs, underwear, medical supplies, etc.

(3) True and evil love: Because the evil of wet poison is evil spirit, its sexuality is sticky, it is difficult to get rid of the body after being invaded, and it is easy to consume the righteousness, which leads to the sinister love, and the condyloma of the vulva skin and mucous membrane is easy to relapse. Hard to eradicate.

Second, Western medicine:

Western medicine research is known to be caused by human papillomavirus (HPV). HPV is a naked type of DNA virus. It is known to have more than 70 molecular biological types, among which HPV6, HPV11, HPV16 and HPV18 are most closely related to human genital genital warts. Humans are the only host of HPV. The disease is mainly transmitted through direct contact, and a small part is infected through indirect contact. The onset, development and recurrence of condyloma acuminata are closely related to the low cellular immune function. Due to the subclinical infection and latent infection of HPV and the low cellular immune function, it is easy to relapse after treatment of condyloma acuminatum.

an examination

Related inspection

Vaginal secretion cytology vaginal fungus test vaginal gynecological routine examination

Examination of vulvar squamous epithelial hyperplasia:

First, clinical features:

Occurs in the external genitalia, anus and foreskin lace, perineum, clitoris, cervix, vagina, etc., also have urethral orifice, urethra, rectum, mouth, nipple, umbilical fossa, groin and interphalangeal, bladder, ureteral involvement . The basic damage of this disease is light red, grayish white or light brown and soft growth, and a few surface keratinization is more obvious. The biological growth varies in size, single or cluster distribution, the surface is lobulated or spinous, moist, the base is narrow or pedicled, the penis body can be seen with a narrow base of "no sputum", and the vaginal damage can be flat. Due to the different distribution of skin lesions, the appearance often appears as granular, linear, overlapping, papillary, cockscomb, cauliflower, and scorpion. It has been reported that because of the discovery of huge type of wet warts associated with the destruction of the underlying tissues, it is called "sickle cancer" and is considered to be a poorly differentiated squamous cell carcinoma. Some wet warts also have the possibility of malignant transformation. Condyloma acuminata often has no symptoms, easy to rub and smash bleeding, a small number of patients have pain and itching, anus, rectum, vagina, cervix genital warts may have pain, sexual pain, local secretions or vaginal discharge, if secondary infection, secretion Increased or insufficient cleaning can be associated with bad odor. Proliferation of the corpus callosum can be induced during pregnancy or when local abnormal secretions are increased or accompanied by other inflammations. Some genital warts can naturally shrink or subside after the end of pregnancy or after delivery.

Second, pathological examination:

Pathological examination found that the hollow cells are characteristic changes of pathology of condyloma acuminata, and have important diagnostic value; followed by pathological changes such as dermal papillary capillary proliferation, basal cell proliferation, spine cell hyperplasia, parakeratosis and keratosis. According to the characteristics of the rash, the location of the disease, and the development of the disease, the contact history may be consulted. The general diagnosis is not difficult. Subclinical infections can be diagnosed either alone or in combination with typical lesions, using the acetic acid white test or the toluidine blue test. For latent infections, in situ hybridization or polymerase chain reaction (PCR) can be used.

Differential diagnosis

Differential diagnosis of vulvar squamous epithelial verrucous hyperplasia:

1. Villi-like labia minora: also known as pseudo-dampness, which occurs in the inner side of the labia minora of young women, around the vestibule of the vagina and the urethra. It is symmetrically densely distributed with white or reddish papules of 1 to 2 mm in diameter and has a smooth surface. It may be in the form of a villus, a fish or a polyp. No obvious symptoms, occasional itching. The acetic acid white test was negative.

2. Sebaceous gland ectopic disease: glans, foreskin or labia minora can be seen in the size of the miliary, isolated and slightly uplifted, in groups or in pieces of yellow-white or light yellow papules, no symptoms. Histologically, each papule is composed of a small group of small mature sebaceous gland lobes, which surround the sebaceous gland duct. The acetic acid white test was negative.

3. Flat wet phlegm: a second-stage syphilis, which is a papule or plaque that occurs in the genital area. The surface is flat and moist. It can also be granular or cauliflower-like. Dark-field examination can detect syphilis, and syphilis is serologically positive. .

4. Bowen-like papulosis: The skin lesions are taupe or reddish-brown flat papules, mostly multiple, round or irregular, with a velvety-like appearance on the surface of the papules or a mild keratinization. Men tend to develop in the penis, scrotum and glans, and women tend to develop in the labia minora and perianal. Generally no symptoms. Histopathological examinations are helpful for identification.

5. Sweat tube tumor: manifested as a small and hard skin color or brown pimples, about a few millimeters in diameter, multiple, usually no symptoms. Histopathological examination can confirm the diagnosis.

6. Genital squamous cell carcinoma: found in those over 40 years old, the lesion is a mass or plaque, infiltration, hard, easy to hemorrhage, often ulceration, histopathological examination can confirm the diagnosis.

7. Pseudocondyloma: The lesion is confined to the labia minora. The miliary is slightly ovate-like reddish papules or villous changes. The surface of the lesion is smooth, the acetic acid white test is negative, and there is no diagnostic empty cell in pathology.

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