Flat papillomas, also known as flat, juvenile or youthful warts, are benign skin growths.. The cause of their occurrence is the human papillomavirus (HPV, papillomavirus), infection with which occurs as a result of direct and indirect contact with a sick person.. Formations are localized mainly on the back surface of the hands, forearms, face in children, adolescents and young people. Treatment of flat papillomas includes various methods of their removal and systemic therapy with antiviral and immunomodulatory drugs..

Flat warts are called juvenile, as children and young people often suffer from them. The photo gives an idea of \u200b\u200bthe appearance of flat papillomas on the face and body.

Causes of appearance Causes juvenile warts human papillomavirus. To date, more than a hundred types of the virus have been identified that can infect the skin and mucous membranes.. One of the most common pathologies that appear as a result of infection with the human papillomavirus is warts.. All of them are divided into eight clinical varieties, each of which is associated with a specific type of HPV..

Clinical variety of the wart.

papillomavirus genotype.

Vulgar (common).

1, 2, 3, 4, 27, 29, 57.

Palmar-plantar deep.

1, 3, 27, 29, 57.

plantar mosaic.

2, 4.

cystic.

60.

flat.

3, 10, 28.

butchers wart.

focal epithelial hyperplasia.

13, 32.

Verruciform epidermodysplasia.

5, 8, 9, 10, 12, 15, 19, 36.

The penetration of papillomavirus occurs through direct contact with the patient or through linen, towels, care items.. An indirect route of transmission of the virus is unlikely, but possible, since viral particles can remain viable for some time in the patient's sloughing skin cells.. For infection, the most minor damage to the surface of the skin and mucous membranes is sufficient..

Forms of existence of papillomavirusIn an infected cell, HPV can be in two different states.

Intracellular form of papillomavirus.

Characteristic.

episomal (benign).

The virus does not integrate into the chromosome apparatus of the infected epithelial cell, being in an inactive or dormant state. There are no clinical manifestations of HPV infection.

Introsomal (malignant).

This form of parasitism of the virus is regarded as malignant, not because it necessarily causes the growth of malignant neoplasms, but because of the aggressiveness of viral particles.. They wake up and penetrate the cell's genome. This process provokes the reproduction of HPV-encoded proteins. In this case, the virus can have a productive or transforming effect on the epithelium.. The first leads to the appearance of benign warts, the second leads to the formation of dysplasia of varying degrees.. In the absence of treatment, the progression of dysplasia leads to the development of cancerous tumors..

Provocative factors The form of existence of the virus in epithelial cells is largely determined by the state of the immune system. A decrease in the overall resistance of the body occurs in a number of conditions, which include:.

prolonged hypothermia;

traumatic injuries;

psycho-emotional overload;

excessive physical labor;

addiction to strong alcoholic beverages;

smoking;

diseases of viral, bacterial, fungal origin;

pregnancy and breastfeeding;

malignant neoplasms;

pathology of the endocrine system;

taking medications (antibiotics, cytostatics, hormones).

The action of provoking factors can be isolated and combined..

Symptoms of flat papillomas Characteristics of warts, called flat ones, are presented in the table.

sign.

Description.

Localization.

Occur most often on the arms (back surface of the hands, forearms), on the face (forehead, area around the mouth) and in areas where hair is regularly shaved: in men - the lower part of the face, in women - shins. Linear placement of papillomas on the face and limbs is characteristic: they are localized along the course of combing and the usual movements of the razor.. The mechanism of formation of such an arrangement is explained simply: a person himself carries viral particles to nearby areas of the skin when combing or removing hair during shaving. This route of infection is called autoinoculation, or self-infection..

Age of patients.

They can be found in patients of various age groups, but most often in children and adolescents, for which they received one of their names - youthful warts..

Appearance.

Usually represented by multiple small nodules, or outgrowths, with a flat, slightly elevated surface and clear outlines. The processes of keratinization of the skin in the area of \u200b\u200bpapillomas do not occur, so they have a smooth and shiny surface without any outgrowths and skin pattern.. Lesions often do not differ in color from normal skin, although color variations are possible: from pink to yellow-brown. Dimensions usually do not exceed a few millimeters (1–5 mm).

Symptoms.

In most cases, the presence of papillomas is not accompanied by complaints.. Possible slight itching. But flat papillomas, especially on the face, are a cosmetic defect and often cause psychological discomfort in the patient..

Diagnosis of flat warts When juvenile warts appear, patients usually turn to a dermatologist. To make a diagnosis, the doctor performs:.

patient questioning;

visual inspection;

dermatoscopy (study using an optical device - a dermatoscope);

laboratory examination for the presence of HPV in the body and its typing (polymerase chain reaction method - PCR).

Differential diagnosis is carried out with other formations on the skin, the main differences of which are presented in the table..

Type of skin formation.

Distinctive features.

Lichen planus.

Flat nodules of lilac, red-violet hue, arranged in groups in the form of garlands, lines, rings. Localization: on the flexor surfaces of the limbs, in the groin, axillary areas, torso, oral mucosa. Nodules have a retracted middle and a surface with a waxy sheen. A characteristic feature is the presence of a network pattern on the surface of the largest formations.. Severe itching is typical.

seborrheic keratosis.

The foci of seborrheic keratosis (hardening and keratinization of the skin) are distinguished by darker pigmentation and look like “pasted” skin formations with a flaky surface. Possible burning sensation when localized on the face.

common wart.

Dry nodules with an uneven surface, covered with outgrowths from the keratinizing epithelium. They can sometimes coalesce to form plaques up to 1.5 cm in diameter.. Typical localization - hands, especially fingers.

Treatment of flat papillomas Spontaneous regression of formations is quite often observed, especially against the background of antiviral and immunostimulating treatment. Patients often insist on the primary destruction of flat warts, which are a cosmetic defect.. The most effective therapeutic direction for skin neoplasms caused by the human papillomavirus is a combination of local destructive effects on warts and systemic use of drugs with immunomodulatory and antiviral effects.. Therapeutic measures can be carried out simultaneously or in stages.

Flat warts can be removed using laser treatment. Removal of flat warts without systemic therapy leads to a high percentage of recurrence of the disease already within 6 months after destruction.. In some cases, formations on the skin are formed on the same areas of the skin as before.. This is due both to the stages of the papillomavirus life cycle and to a decrease in the general and local immune response..

The variability and species diversity of HPV do not allow for its complete elimination from the body, so the main task of systemic treatment is to transfer the virus to an inactive, or latent, state..

The main therapeutic measures are presented in the table.

Medical direction.

Characteristic.

Removal of flat papillomas.

There are several ways to get rid of: the use of salicylic acid preparations, freezing with liquid nitrogen, laser therapy, radio wave removal. Treatment should not be traumatic and accompanied by scarring. For this reason, surgical excision and electrocoagulation are usually not used, especially when papillomas are localized on the face..

The most widely used preparations of salicylic acid in the form of a liquid or patch, as well as cryotherapy through applications of liquid nitrogen. The freezing procedure does not require anesthesia and is therefore well tolerated even by small patients..

Increased systemic and local immune response.

To increase the body's resistance, immunomodulatory and antiviral drugs are used: Interferon, Cycloferon, Allokin-alpha, Likopid, Immunomax, Aldara. The presence of drugs in various dosage forms (injectable solution, ointment, cream) facilitates their combination in order to achieve an effective result..

Folk methods There are folk recipes for getting rid of juvenile warts at home using celandine, garlic, lemon, acetic acid. However, it is difficult to effectively deal with the problem only with their help: even successful destruction of formations (which occurs infrequently with this method) does not lead to recovery.. Antiviral drugs and correction of immunity are necessary, otherwise a relapse of the disease is very likely. Do not self-medicate.

How to avoid relapses For successful treatment, patients with flat warts need to:.

follow the advice of a specialist;

do not scratch the skin in the area of \u200b\u200bformations;

do not use a razor used to remove hair in the area of \u200b\u200b\\u200b\\u200bfoci on healthy areas of the skin;

lead a healthy lifestyle.

A high level of immunity will prevent the recurrence of neoplasms.

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