Oral papillomas are benign neoplasms in the oral cavity that grow from epithelial cells. Papillomas are discovered during a dental examination and look like separate growing seals on a small stalk, they are painless and have a white or pale pink color.
This type of neoplasm in the oral cavity is diagnosed most often. About 60% of patients are women aged forty years, about 20% are teenagers of any gender. Often, adults experience the appearance of individual papillomas, while children may experience so-called papillomatosis (multiple papillomas). In half of the cases, papillomas are localized on the mucous membrane of the tongue.
Causes of papilloma in the mouth
The most common cause of this type of tumor is the human papillomavirus (HPV).
Factors that provoke the appearance of papillomas in the oral cavity are, for example, constant microdamage to the cheeks and tongue. A relatively small damage is enough for viral particles to penetrate inside and trigger the formation of papilloma. In children, the provoking factor is a too short frenulum of the tongue - the lower incisors injure it, creating a gateway for infection.
When analyzing papilloma under a microscope, it can be noted that this neoplasm is a tumor, which consists of many layers of epithelial tissue, which in some places has become significantly keratinized. In some areas, traces of the appearance of a focus of inflammatory infection can be noted.
How to find out about HPV infection if there are no symptoms?
There is a study that finds the papilloma virus causing cervical cancer. This examination is recommended for all women over 30 years of age. Thanks to the analysis, the papilloma virus can be detected before it causes pathological changes in the cervix.
Do not confuse an HPV test with a Pap test. During a Pap test, a smear taken from the cervix is examined at the cellular level. If oncogenic HPV is suspected, both tests should be performed.
Classification of oral papillomas
Based on the number and concentration of neoplasms, oral papilloma is differentiated from papillomatosis – a massive accumulation of neoplasms in one place.
According to their origin, papillomas are divided into the following types:
- Traumatic (reactive) papilloma. May appear after traumatic effects of a mechanical, chemical or temperature nature. A distinctive and characteristic feature of reactive type oral papilloma is that their growth stops immediately after the irritant that caused them is eliminated.
- True (neoplastic) papilloma. This type of papilloma begins to develop after the mechanism of cell division, growth, and differentiation is disrupted. In most cases, this type of papillomas appears in the distal part of the cheek, in the area located behind the molars and in the area of the pterygomandibular fold.
- Viral papilloma of the oral cavity. May appear after the patient has been infected with the human papillomavirus. This type of infection occurs through direct contact with a carrier of the virus. When the integrity of the oral mucosa is compromised (for example, due to microtrauma), a path for infection appears.
Symptoms
Symptoms characteristic of genital herpes appear suddenly. A rash appears in the area where the virus entered the body. Fluid-filled blisters become enlarged and painful. The affected area is very itchy. Then the bubbles burst, and the skin in this place becomes covered with a crust.
Often the disease is asymptomatic or with such a minor rash that the patient may not even notice it.
The rash appears a few weeks after infection and lasts about 2-3 weeks. Sometimes the inguinal lymph nodes become swollen and painful. Other symptoms may include joint pain, fever, headache, and sometimes even painful urination. Nausea, dizziness, and difficulty urinating are rare and indicate damage to the nervous system.
The rash may disappear, but this is not the end of the disease. After the initial outbreak, the virus enters a latent phase and continues to live in the spinal cord. The disease usually appears several times a year, although the symptoms are most acute during the first outbreak, then they become increasingly rare and less noticeable. The frequency of relapses varies from person to person. It depends on the type of virus and the person's immune system.
Treatment of oral papillomas
Diagnosis of this disease includes a collection of the patient’s medical history, as well as a thorough histological examination of removed papillomas.
Treatment of papillomas is only surgical. The neoplasm is excised down to the borders of healthy tissue. Techniques such as electrocoagulation, cryosurgery, sclerotherapy and others are rarely used, since as a result of their implementation it is impossible to conduct a histological analysis of the papilloma removed to the base.
If a large accumulation of papillomatous neoplasms is detected, a combined technique is used: a scalpel is used to dissect the largest number of papillomas accumulated in one place, and single papillomas are removed using electrocoagulation.
If oral papillomas have a viral etiology, antiviral and immunomodulatory therapy is prescribed along with surgical intervention to prevent relapses.
Depending on the etiology of the disease, relapses may occur with greater or lesser probability. So, if there is a human papillomavirus in the body, the risk of papillomas returning after surgery is quite high.
How to cure papillomavirus
Unfortunately, it is impossible to remove the papilloma virus itself from the body. But it is possible to cure diseases caused by this virus - genital warts, changes in the cervix, cervical cancer.
There are several ways to treat genital warts, all of which are painless and effective. If genital warts are left untreated, they can grow and multiply over time.
All women who are or have been sexually active should have regular Pap tests. Thanks to this precise diagnosis, changes in the cervix can be detected at the cellular level even at very early stages. Therefore, the problem will be solved before cervical cancer appears. Timely diagnosis is a prerequisite for effective treatment.
Where did AIDS come from?
AIDS (acquired immunodeficiency syndrome) was first described in the United States in 1981, when several cases of the rare diseases Pneumocystis pneumonia and Kaposi's sarcoma were diagnosed.
These diseases were previously found only in patients with immune system disorders, so doctors suspected immunodeficiency. They soon became convinced that they were dealing with a new disease, which in 1982 the US Centers for Disease Control and Prevention officially registered as a new disease - acquired immunodeficiency syndrome (AIDS).
In 1983, the virus that causes the disease, called human immunodeficiency virus (HIV), was discovered.
During this time, many theories appeared about the origin and spread of the disease. Africa is the birthplace of AIDS. where the simian immunodeficiency virus, which causes the same disease as the human immunodeficiency virus, was discovered. As a result of mutation, the virus changed its appearance and became dangerous to humans.
The virus spread in Africa and spread to other countries where the blood of the African population was used for medical purposes. People infected with HIV-infected blood spread the virus through needles and syringes and sexual contact.
Mononucleosis
This disease is also caused by the herpes virus, but not the first type, but the fourth. This virus is also called the Epstein-Barr virus. The virus enters the body through saliva and begins to multiply in the mouth and throat. For this reason, it is very easy to become infected with mononucleosis through a kiss. This disease even has a third name - “kissing disease.” Symptoms of mononucleosis are high fever, sore throat, and swollen lymph nodes. Symptoms do not begin to appear immediately, but after a couple of weeks.
What are the consequences of HPV during pregnancy?
To date, there is no reliable evidence of a pronounced negative impact of infection on the course of pregnancy.
Pregnancy pathologies such as miscarriage, premature birth, etc., which are characteristic of other sexually transmitted infections, have not found unconditional confirmation of the connection with HPV.
However, if a woman’s primary infection occurs during pregnancy, there is a risk of developing various complications.
Anogenital warts in the mother caused by HPV types 6 and 11, localized in the area of the labia minora and the vestibule of the vagina, have some consequences for the fetus during pregnancy.
Such genital warts carry a small risk of infection of the fetus during childbirth, leading to the development of respiratory papillomatosis in the latter.
Respiratory, or otherwise laryngeal, papillomatosis (also called laryngeal papillomatosis) most often develops in children 2 to 3 years old.
As a result of infection from a sick mother during the latter’s pregnancy or immediately at birth.
The route of transmission during pregnancy through the placenta, during childbirth or immediately after it is not yet entirely clear.
The main symptoms of the disease are hoarseness, up to the complete disappearance of the voice, and difficulty swallowing.
As the disease progresses, shortness of breath and cough appear.
In severe situations, blockage of the upper respiratory tract and asphyxia are possible, especially in the case of formations with a long thin stalk.
During examination using a laryngoscope (sometimes a bronchoscope is also used), typical growths - condylomas - are found on the laryngeal mucosa.
This pathology has a rather aggressive course: after removal of the formations, relapses often occur, requiring repeated surgical interventions.
If pregnancy occurs due to infection with highly oncogenic papillomaviruses (especially HPV 16, 18), the woman must inform her obstetrician-gynecologist about the presence of infection.
The fact is that changes in a pregnant woman’s body can provoke more intense cell transformation.
Actually, such viruses do not affect the course of pregnancy itself or the child, but they pose a certain threat to the woman’s health.
In a situation where no infection was detected in the past, a cytological Papanicolaou smear (Pap test) is taken, among others, when registering.
If the analysis shows abnormalities, the doctor prescribes additional tests (for example, colposcopy).
Also, situations when pregnancy occurs in women with erosion require special attention.
PCR diagnostics are required to exclude infection with high-oncogenic risk HPV.
As a rule, in the routine practice of an obstetrician-gynecologist, such a combination as HPV and pregnancy is not specifically examined.
Tests for the virus are recommended only if pathological abnormalities are detected.
At the same time, there are research studies demonstrating the effect of the virus on pregnancy.
Thus, it has been shown that infection of women with HPV slightly reduces the likelihood of embryo implantation, and in men it reduces sperm motility.
And since in a married couple, as a rule, both partners are infected, the onset of pregnancy is associated with some difficulties.
As a result, when planning a pregnancy against the background of an infection caused by HPV, planning an IVF procedure, this factor should also be taken into account.
What is human immunodeficiency virus? Why is it impossible to protect against it by vaccination?
HIV is a retrovirus and is characterized by strong mutagenicity—it changes its appearance very quickly. Therefore, it is very difficult to create a vaccine for it. In this case, the genotype of the virus changes from one person to another.
Members of the retrovirus family are characterized by a long incubation period, which means that a virus that enters the body lives there for years, multiplies, damages the body, but does not manifest itself clinically. A patient can be a carrier of the virus for 5-7 years, at the same time be a source of infection, and not know about it until a direct test for HIV infection is carried out.
How safe is HIV/AIDS?
AIDS is not transmitted through household items. It is dangerous to use only the patient's razor, scissors and other objects that come into contact with blood.
There is no risk of sharing a bathroom, bed linen, towels, dishes, kissing, hugging, studying or working in the same room with the patient. Doctors are often asked, is HIV/AIDS transmitted through mosquito and dog bites? No, HIV does not spread this way. There are only three routes of transmission: sexual contact, blood and vertical transmission.
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What is the main way HIV spreads?
There are three ways to transmit the virus:
- Unprotected sexual contact;
- Through blood. This route includes blood transfusions, medical manipulation of non-sterile instruments, and the sharing of a needle, syringe, or other injection device;
- Vertical transmission is the infection of the fetus by an infected pregnant woman during childbirth or breastfeeding.
Route of spread of HIV
Risk groups include:
- Injecting drug users who have at least once used a needle, syringe or other injection device that was used by someone else;
- Persons who have frequent unprotected sexual intercourse (both heterosexual and homosexual);
- Patients who have had a sexually transmitted infection;
- Infected with hepatitis B and C.
Also at risk are patients on hemodialysis and patients who are frequently exposed to medical procedures.
High oncogenic HPV type
The above-described viruses of types 16 and 18 are at high risk of cancerous degeneration of the epithelium.
Also included in this type are strains 70, 68, 64, 59, 50, 39, 33, 31.
The second group is of average oncogenic risk.
It is possessed by strains type 58, 56, 53, 52, 45, 35, 30.
Strains 73, 72, 61, 51, 44 to 40, 34, 32, 13, 11, 6, 3 are considered low risk.
Low-risk viruses often cause only the formation of benign papillomas or condylomas.
Such formations in men more often affect the skin of the penis (leaves of the foreskin, coronary groove, less often found inside the urethra on the mucous membrane).
In women, the location of these growths is the labia minora and majora, and the perianal region.
Risk areas include skin or mucous membranes injured during sexual intercourse and areas of epithelial maceration.
Pregnancy and genital herpes
If the first outbreak of genital herpes occurs closer to the time of birth, the risk of infection in the newborn increases. Therefore, childbirth should be carried out taking into account safety measures.
Because herpes in newborns is a very serious condition, a pregnant woman should tell her doctor in advance. If the disease recurs several times during pregnancy, it is recommended to treat with acyclovir, and if childbirth coincides with a period of exacerbation, a caesarean section is prescribed.
How long will the window period last?
The window period usually lasts 6-8 weeks, but if the analysis was performed using 4th generation tests, this period can be reduced to 4-6 weeks. After the pre-test consultation, the patient is offered an HIV test, which involves detecting HIV antibodies and is called screening or initial testing.
If the initial screening is negative, it means the person is not infected. If the answer is positive, the study should be continued with confirmation methods (immunoblotting method, polymerization chain reaction method).
Diagnosis of children under one year of age born to HIV-positive mothers is carried out only by the polymerization chain reaction method.
