Bovenoidny — the sexually transmitted disease caused by a virus of papilloma of the person, which is shown eritematozny spots, papules or plaques and proceeding with damage of skin of genitals, crotches, perianalny area or hips. Bovenoidny treats precancer conditions of skin. Diagnostics of a bovenoidy papulez is based on a clinical picture, PTsR-detection of a virus of papilloma of the person, negative serological reactions to syphilis, results of a histologic research. Treatment of a bovenoidny papulez consists in performing the general antiviral therapy and removal of skin elements the laser, electrothermic coagulation, excision or cryodestruction.
Bovenoidny was described as a pigmentary multiple form of a disease of Bowen in the beginning. Then its communication with a virus of papilloma of the person was revealed. Men and women, generally at the age of 17-40 years are subject to a disease of a bovenoidny papulez. In clinical venereology separate cases of emergence of a bovenoidny papulez at children including at newborns whose mothers had this disease were also observed.
Bovenoidny — rather rare disease. However the tendency to increase in number of the diseased was outlined recently that connect with growth of chaotic sexual communications in society.
Causes of a bovenoidny papulez
Etiologichesky factor of a bovenoidny papulez is the virus of papilloma of the person (VPP) which also causes developing of condylomas, warts and papillomas. Most of authors indicates communication of a disease with VPCh 16, 18, 31, 33 of types. Separate researches demonstrate detection at patients with a bovenoidny papulez and other VPCh types.
Infection with a bovenoidny papulez, like other venereal diseases (gonorrhea, syphilis, clamidiosis, ureaplasmosis and so forth) occurs sexually. The incubatory period can borrow from 2-3 months to several years.
Symptoms of a bovenoidny papulez
Rashes of a bovenoidny papulez can be presented by the spots of red color pigmented or likhenoidny papules, plaques, similar to a leukoplakia. Elements can have multiple or single character, the size from several millimeters to 3-3,5 cm. Usually they are not followed by subjective feelings, in certain cases patients complain of an itch. At development of an inflammation morbidity appears.
Pigmentary papules of a bovenoidny papulez have red-brown, pink, violet or yellowish coloring. Their consistence pasty, surface usually smooth, sometimes warty. Likhenoidny papules of a bovenoidny papulez represent local thickenings of skin with the strengthened and rough skin drawing. They have color of usual skin and a rough surface more often, can be covered with serous crusts. Separate papules merging among themselves, form plaques. Leykoplakiyepodobny plaques are painted in milky-white or grayish-white color, their edges are accurately delimited from healthy skin.
The most typical arrangement of elements of a bovenoidny papulez at men on a penis, at women — on a clitoris and vulvar lips. Localization in inguinal area, on skin of hips and a crotch, around an anus, on a mucous membrane of a mouth and a throat is possible. As a rule, on a penis trunk at men, in a vulva and around an anus at women the pigmented papules, on a penis head — likhenoidny are noted.
Along with manifestations of a bovenoidny papulez at patients warts and peaked condylomas are often observed. The combination of a bovenoidny papulez to a uterus neck dysplasia occurs at women.
The long current without progressing of process with the periods of spontaneous remissions is characteristic of a bovenoidny papulez. Spontaneous permission of a disease was in some cases observed. However, despite the seeming inoffensiveness of a bovenoidny papulez, it treats precancer diseases of skin. Always there is a probability of transformation of its elements in planocellular cancer of skin of genitals, Bowen's disease, penis cancer at men or vulva cancer at women. Due to these patients with a bovenoidny papulez have to stay on the dispensary registry at the venereologist or the dermatologist and to regularly have examinations.
Diagnostics of a bovenoidny papulez
Elements of a bovenoidny papulez can be revealed when carrying out survey on consultation of the gynecologist, urologist or andrologist. In such cases the patient goes to the venereologist who establishes the diagnosis, based on clinical yielded, results of PTsR-diagnostics, a cytologic and histologic research of the material received from an affected area of skin.
PTsR-researches are directed to identification and typing of a virus of papilloma of the person. They are carried out with the scrape, blood of the patient or dabs taken from genitals. For an exception of the syphilitic nature of skin elements their research on a pale treponema, serological diagnostics (the RPR test, RIBT, RIF) is conducted.
The cytologic research of scrape or dab print of elements of a bovenoidny papulez reveals existence of a koylotsitoz — a large number of epiteliotsit with a characteristic enlightenment around a kernel, and also cages with the doubled kernels. The histologic picture of a bovenoidny papulez corresponds to in situ cancer. Proliferation of keratinotsit and atypical mitoses is observed. Polymorphic atypical cages, characteristic of a bovenoidny papulez, with hyperchromic kernels are diffuzno disseminated through all thickness of epidermis while at Bowen's disease similar cages settle down compact groups.
Treatment of a bovenoidny papulez
Need of treatment of a bovenoidny papulez is dictated by probability of its ozlokachestvleniye. Cryodestruction, laser removal, electrothermic coagulation or surgical excision of elements of a bovenoidny papulez is made. Also drawing tsitostatik (the chloride prospidiya, ftoruratsit) on affected areas of skin or their obkalyvaniye is applied by interferon. Local treatment of a bovenoidny papulez is followed by the general antiviral therapy.
It should be noted that bovenoidny it is inclined to a frequent retsidivirovaniye and even its complex treatment is not always rather effective.
Prevention of a bovenoidny papulez
The measures directed to the prevention of infection with development of a bovenoidny papulez correspond to the general principles of prevention of STD. They include first of all reasonable sexual behavior and use of condom during sexual contact.