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Bradavice za Dr Galeba
karirani
(d)
17. септембар 2009. у 11.17
Pomozite mi molim vas.
Pre sest meseci prmetio sam malu izraslinu dole na dlakavom delu.
Ja sam to istisnuo i izasla je neka zuckasta bela sirasta masa.Na jednom prstu sam imao bradavicu.Malo je krvarilo i prošlo.
Za par dana tu je se pojavilo vise malih ispupcenja crvenkaste boje i boje koze.
Otisao sam kod državnog doktora i on je ovo napisao„ molluscum contagiosum reg. pubis (B07) i predlozio terapiju tecnim azotom.
Zatim sam otisao kod privatnika i on je rekao da su kondilomi i spalio ih je.
Pre dva dana sam opet primetio tri male izrasline i otisao kod privatnika.On je rekao da nije siguran da li su kondilomi ili neke upale ali ih je ipak spalio.
Da li je istina da se ovi nalazi razlikuju???
Kako i gde da se testiram da li imam HPV ili molluscum contagiosum.
Hvala na odgovoru .

OPIS-50
(OPISIVAC)
17. септембар 2009. у 11.36
Molluscum contagiosum je benigno oboljenje kože koje se manifestuje u vidu bubuljica voštanog izgleda sa tačkastim udubljenjem u centru.
Kako se manifestuje molluscum contagiosum?
Najčešće su promene lokalizovane na koži lica, genitalijama i pregibima u vidu pojedinačnih ili grupisanih poluloptastih tvorevina nežnog perlastog izgleda sa diskretnim udubljenjem u centru. Najčešće su asimptomatske, mada u slučaju sekundarne bakterijske infekcije jako svrbe, a češanjem se obično promene dalje rasejavaju (autoinokulacija). Najčešće se to dešava kod dece atopičara (tzv.Eczema molluscatum).

Kako se otkriva bolest?
Za postavljanje dijagnoze je sasvim dovoljan izgled i lokalizacija promena kao i to da se pritiskom na promene istiskuje beličasta sirasta masa. Moguće je naravno mikroskopski dokazati mnogobrojna moluskum telašca koja su zapravo virusom transformisane ćelije epiderma.

Lečenje
Moguća je spontana regresija (posle 6 meseci), ali i rasejavanje postojećih promena. Najbolji rezultati se postižu mehaničkim uklanjanjem promena: iglom, skalpelom, kiretom, a zatim nastale erozije premazati jodom. Može se primeniti i krioterapija, terapija radiotalasima. Nakon završetka terapije potrebne su kontrole zbog moguće pojave novih promena.

karirani
(d)
17. септембар 2009. у 12.21
Hvala na brzom odgovoru.Sada su mi sve promene tretirane spaljenje tako da ne primecujem ni jednu.Da li sada može da se ustanovi prisustvo virusa?Da li virus može da se otkrije iz krvi.
Ako prođe vise od godinu dana da li to znači da se neće vise javljati.
Da li kopd žena predstavljaju problem prilikom porodjaja?
Galeb
18. септембар 2009. у 19.24
Vi prvo trebate razjasniti šta je kod vas u pitanju. Nije isto Condylomata acuminata i Molluscun contagiosum.
Kako vas lijece kao Condylomata acuminata evo vam u vezi toga sve sto vas interesuje:
Condylomata Acuminata
Condyloma acuminatum is the most common sexually transmitted disease in the United States and manifests most commonly as a warty lesion on the penis or scrotum in males. The cause is HPV infection, which is estimated to be present in as many as 5% of adults aged 20-40 years (see Condyloma Acuminatum). Infection with specific types of HPV is associated with the development of anogenital squamous intraepithelial lesions and carcinoma.

Pathophysiology
The cause of condyloma acuminatum is the nonenveloped DNA virus HPV. HPV is also the cause of planar warts, plantar warts, verrucae vulgaris, and Bowenoid papulosis. More than 80 different genotypes of HPV have been identified, and different genotypes have a predilection for specific anatomical regions of the skin or mucosa. In most cases, HPV infection causes benign epithelial proliferations that may range from asymptomatic to disfiguring lesions. Some strains of HPV, however, play a significant pathogenic role in the development of carcinoma, particularly cervical carcinoma, but also anal and penile carcinoma.
HPV displays tropism for epithelial cells of the host. It is spread by skin-to-skin contact and is most readily inoculated into epithelium with impaired integrity. After attaching to host cells, the virus may spread through direct spread or autoinoculation, but it does not become blood-borne. HPV infects the basilar layer of epithelium or epidermis, where it incorporates its DNA and, after a variable incubation period of up to several months, induces proliferation. As the basilar compartment of cells proliferate and differentiate, the virus begins to replicate. Because of various viral and host-related factors, a clinically apparent lesion may develop. The host immune response to HPV infection is not well understood. However, both cellular and humoral immunity play a role in controlling or eradicating infection.
HPV types 6 and 11 are the most common cause of benign condyloma acuminatum that appears on the external genitalia. Types 16 and 18, and, less commonly, 31, 33, and 35, are high-risk HPV strains and are the types most commonly involved in the development of cervical carcinoma. Recently, the mechanisms of oncogenic potential of HPV has become better elucidated. Viral proteins, specifically E6 and E7, of high-risk HPV types have been shown to alter cell cycle and apoptotic responses in the host cell. High-risk types of HPV express E6, which interacts with and alters the function of tumor suppressor gene TP53, and E7 binds to retinoblastoma protein (RB), leading to a loss of cell-cycle control.

Clinical presentation/diagnosis
Condylomata on the male genitalia are typically acquired through sexual transmission. In fact, the association between men with penile condylomata and sexual partners who have cervical lesions is high (50-85% of males whose sexual partners have HPV lesions have penile lesions). The exact incubation period is unknown but averages several months. Condylomata may be located anywhere on the scrotum or penis, including on the glans or corona or adjacent to the meatus. Perineal and anal lesions are also common sites of involvement.
They typically present as asymptomatic, skin-colored-to-brown, sessile, cauliflowerlike lesions and can measure 1 mm to a few centimeters in size. Occasionally, the lesions appear as flat-topped or barely elevated papules. Although sometimes solitary, a significant portion of those affected have more than one lesion at presentation. In most cases, the diagnosis is made based on history and physical examination. Skin biopsy can be used for diagnostic confirmation, if necessary.
The histopathologic features of condyloma acuminatum show epidermal papillomatosis with hyperkeratosis and acanthosis. Focal vacuolated keratinocytes (koilocytes) are typically present in the epidermal granular layer. HPV can be demonstrated with immunohistochemistry in most lesions. Atypia of keratinocytes is minimal to mild unless significant squamous dysplasia is present.

Differential diagnosis
The differential diagnoses include condyloma latum, seborrheic keratoses (see Seborrheic Keratosis), nevi, molluscum, and pearly penile papules (see Pearly Penile Papules). In immunocompromised patients, particularly individuals with HIV seropositivity, other sexually transmitted disease such as nodular herpesvirus infection should be considered. Malignancies such as Bowen disease and squamous cell carcinoma must also be considered, particularly in patients who present with refractory or atypical lesions.

Treatment
A number of therapeutic options exist, but no treatment is virus specific. Most therapies involve destruction or removal of clinically apparent virally infected skin. Therapies most commonly used include cryotherapy, podophyllin, imiquimod cream, and podophyllotoxin 0.5% solution or gel. The former two are applied by the treating physician. The latter two are patient-applied therapies and are often used in conjunction with the former. Imiquimod is applied to lesional skin on alternating nights thrice weekly for several months. Podophyllotoxin is applied bid 3 consecutive days each week and repeated for up to 3-4 months. Electrodesiccation, laser ablation, topical 5-fluorouracil, and surgical excision are other options if the above are ineffective. Because it is mutagenic, podophyllin should be used with caution in males infected with HIV and is not recommended for urethral lesions, in which case 5-fluorouracil 5% or thiotepa is preferred.

Outcome
Condylomata may regress spontaneously; however, approximately half persist and require therapy. Female sexual partners are at high risk for cervical dysplasia, depending on the HPV subtype, and should be screened with routine Papanicolaou smear. Sexual abuse must be suspected and excluded in children with genital condylomata. In high-risk individuals, particularly immunocompromised patients, a high clinical suspicion for malignant transformation must be maintained given the association with HPV and carcinoma.

Ako vas interesuje o Molluscum contagiosum i to vam mogu preneti da ne pišem jer je puno a ne znam šta vas interesuje. Navedena pitanja koje ste postavili mozete naći u navedenom tekstu.
Sve najbolje Galeb
karirani
(d)
19. септембар 2009. у 13.00
Hval dokore na odgovoru.
Ja sam iz Uzica pa ako postoji neka ustanova u okolini koja radi tipizaciju HPVa bio bih vam zahvalan da mi kazete gde.
Hvala unapred na odgovoru.
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