사람 유두종 바이러스와 사람 유두종 바이러스 감염병, Human papillomaviruses and human papillomaviruses infections

사람 유두종 바이러스와 사람 유두종 바이러스 감염병, Human papillomaviruses and human papillomaviruses infections

 

사람 유두종 바이러스 humanpapilloma virus 감염병 사람 유두종 바이러스 감염으로 생기는 바이러스 피부 감염병을 사마귀라고 한다. 사마귀가 나 있는 신체 부위, 사마귀의 모양, 사마귀를 일으킨 바이러스의 종류에 따라 사마귀는 여러 종류로 분류된다. 약 100여 종의 사람 유두종 바이러스가 사람의 피부와 점막층에 감염되면 사마귀가 생긴다. 사마귀는 다음 같은 보통 사마귀(심상성 사마귀/Genital Warts) 발바닥 사마귀(족척우췌/Plantar warts) 손톱 주위 사마귀(조갑주위 우종), 물 사마귀(전염성 연속종/Molluscum coatsiosum) 사상 사마귀(엽상 우췌/Filiform warts) 평편 사마귀(Flat warts) 첨형콘딜로마(콘딜롬/Condyloma acuminatum), 재발성 후두 유두종증(Recurrent laryngeal papillomatosis) 등 여러 종류가 있다. 사마귀의 종류에 따라 사마귀가 나는 신체 부위가 다르다. 사마귀는 얼굴, 몸, 코, 손가락, 손바닥, 손톱 주위, 발바닥, 외부생식기, 항문, 결막, 입안 점막층, 기도 등에도 날 수 있다. 보통 사마귀는 미관상 흉하게 보일뿐 건강이나 생명에 큰 지장은 주지 않으나 불편스럽고 성가시게 한다. 대개 아무런 치료를 하지 않아도 자연히 낫는다. 후두에 난 사람 유두 바이러스 사마귀(재발성 후두 유두종증)는 목을 쉬게 하고 생명에도 위험할 수 있다. 자궁 경부, 항문,  생식기, 구강, 인두 부위 등에 난 사마귀에 이형성이 생길 수 있고 암으로 변할 수 있다. 어떤 소아청소년들에게는 사마귀가 더 잘 나고, 다른 소아청소년들에게는 사마귀가 잘 나지 않는다. 그 이유는 아직도 확실히 밝혀지지 않았다. 보통 사마귀(심상성 사마귀), 사상 사마귀, 편평 사마귀(연소성 편평 사마귀), 콘질음(습성 사마귀 또는 첨형 사마귀), 발바닥에 난 보통 사마귀(족저 우종 또는 족척 사마귀), 첨형콘딜롬(콘딜로마/HPV Infection/Condyloma acuminatum), 재발성 후두 유두종증(Recurrent laryngeal papillomatosis)과 재발성 호흡기 유두종증 (Recurrent respiratory papillomatosis(RRP) 참조

■ 원인

• 사람 유두종 바이러스 감염병은 100여개가 되는 사람 유두종 바이러스 종에 감염되어 생길 수 있다. 
• 사람 유두종 바이러스(human papillomavirus/HPV) 감염병의 종류에 따라
• 사람 유두종 바이러스(human papillomavirus/HPV)에 감염되면 다음과 같은 여러 종류의 유두종이 생길 수 있다.

1. 보통 피부 사마귀(Common skin warts)

• 표면이 꺼칠꺼칠하고 반구형 원추형 모양으로 생기고 무통이고 여러 개 나있는 것이 보통이다.

• 손에 나있을 수 있고 손톱 바로아래 또는 손톱 주위에 나있을 수 있다.
• 사마귀의 피부가 벗겨지면 모세혈관에 검은 혈전이 생길 수 있다.
• 발바닥에 나있는 발바닥 사마귀(Plantar wart)으로 인해서 아플 수 있고 검은 혈전이 생길 수도 있다.

2. 편평사마귀 (Flat warts/“juvenile warts”)

• 얼굴이나 팔 다리 등에 날 수 있다.
• 사마귀는 작고 여러 개가 나있을 수 있고
• 사마귀 꼭대기가 납작하고 아프지는 않다.

3. 실 사마귀(실모양의 사마귀/Filiform warts)

• 얼굴과 목에 나는 것이 보통이다.
• 사마귀 표면이 실같이 가늘고 뾰쭉뾰쭉하다.

4. 성병 사마귀 (Anogenital warts/Condylomata acuminata)

• 주위 피부색과 같고 콜리플라워 모양의 표면,
• 수 mm~수 cm 크고
• 남성의 음경이나 음낭, 항문 또는 항문 주위에 날 수 있다.
•  여성의 외음부, 항문주위, 질 강, 자궁 경부에 날 수 있다.
• 보통 아프지는 않지만 가렵고 화끈거리고 국소 통증이 생길 수 있고 출혈이 생길 수 있다.

5. 지속적 항문 주위 사람 유두종 바이러스 감염병

• 여성의 자궁 경부와 질 강 등 여성의 생식기에 나있을 수 있고
• 퍂(Pap)검사의 결과에 비정상 세포가 발견될 수 있고
• 생체검사에 종양세포가 나타날 수 있다.
• 같은 조직검사 결과가 다른 생식기의 다른 부위에도 나타날 수 있고 항문 점막에도 날 수 있다.
• 이런 종양성 변화가 자궁 경부, 질부, 음부, 음경, 항문, 구강, 인두 등에도 나타날 수 있다.

6. 소아 재발성 호흡기 유두종(유년 재발성 호흡기 유두종/Juvenile recurrent respiratory papillomatosis) 

• 상기도나 후두에 생기는 재발성 유두염이다.
• 보통 2~3세 유아들에게 발병되고 이 병이 있으면 음성이 변하고 비정상이고 협착음이 생길 수 있다.
• 병이 진행되면 하기도가 차단될 수 있다.

7. 표피형성 이상 사마귀(Epidermodysplasia verruciformis/EV) 

• 드문 병이다. 만성 피부 사람 유두종 바이러스 감염병이다.
•  이 병은 피부암으로 발전될 수 있다.

■ 잠복기

• 확실히 모른다.
• 사람 유두종 바이러스 감염병의 종류에 따라 다르다.
• 약 3개월 내지 길게는 10년이다.

■ 진단

• 대부분의 피부는 인간 유두종 바이러스 감염병 즉 사마귀는 병력 증상 징후 진찰소견을 종합해서 진단한다.
• 호흡기 유두종은 내시경 검사와 생체 조직검사로 진단한다.
• 자궁 경부 유두종바이러스 감염병으로 인해 생긴 형성이상은 생체조직 검사로 진단한다.
• 바이러스 검출로도 진단할 수 있고 Cervista HPV HR검사 등으로 진단할 수 있다.
• 혈청검사로 진단하지는 않는다.

■ 치료

• 성병 사마귀 (Anogenital warts)는 자연적으로 몇 개월 내에 없어질 수 있다.
• 자연적으로 없어지지 않으면 화학물질 치료, 물리적 치료, 살리실릭산 액제, 나이트로젠 액제, 수술치료, 레이저 치료, Tretinoin이나 Cimetidine 등 약물로 치료한다.

■ 예방

• 9가 사람 유두종바이러스 백신(9-valent HPV/9 v HPV) 효과가 100% 난다고 한다. 4v HPV와 2v HPV 백신도 효과가 좋다고 한다.

Human papillomaviruses and human papillomaviruses infections

Human papillomavirus infectious disease

• Viral skin infections caused by human papillomavirus infection are called warts.

• Warts are classified into several types, depending on the part of the body where the wart is located, the shape of the wart, and the type of virus that caused the wart.

• About 100 types of human papillomaviruses infect human skin and mucous membranes, causing warts.

There are many kinds of warts as following

• Common Warts /Genital Warts)

• Plantar warts

• Perinail warts (peri-nail warts);

• Water wart (Molluscum contasiosum)

• Filiform warts

• Flat warts

• Condyloma acuminatum,

• There are several types, including recurrent laryngeal papillomatosis.

• Depending on the type of wart, there are different parts of the body that have warts.

• Warts can also appear on the face, body, nose, fingers, palms, around nails, soles of the feet, external genitalia, anus, conjunctiva, mucous membranes of the mouth, and airways.

• Usually, warts look unsightly and do not pose a major threat to health or life, but they are uncomfortable and annoying.

• It usually heals spontaneously without any treatment.

• Human papillomavirus warts of the larynx (relapsing laryngeal papillomatosis) can cause hoarseness and even life-threatening. Warts on the cervix, anus, genitals, oral cavity and pharynx can become dysplastic and can turn into cancer.

• Some children and adolescents are more prone to warts and others are less prone to warts. The reason is still not clear.

• Common warts (warts Vulgaris), filamentous warts, flat warts (juvenile squamous warts), condylomas (wet warts or warts acuminate), common warts on the soles of the feet (plantar warts or plantar warts), condyloma acuminus (condyloma/HPV) Infection/Condyloma acuminatum), Recurrent laryngeal papillomatosis and Recurrent respiratory papillomatosis (RRP)

■ Cause

• Human papillomavirus infection can be caused by infection with more than 100 human papillomavirus species.

• Depending on the type of human papillomavirus (HPV) infectious disease • Human papillomavirus (HPV) infection can cause several types of papillomas as follows.

1. Common skin warts

• It has a rough surface, is formed in the shape of a hemispherical cone, is painless, and it is common to have several.

• It can be on the hand, just under the nail or around the nail.

• When the wart’s skin peels off, black blood clots can form in the capillaries.

• Plantar warts on the soles of the feet can be painful and cause black blood clots.

Picture 435. Common wart on the back of the hand Copyright ⓒ 2012 John Sangwon Lee, MD., FAAP

Picture 430. Common warts on the palms of the fingers and hands Copyright ⓒ 2012 John Sangwon Lee, MD., FAAP

Picture 429. Common warts around the nails Copyright ⓒ 2012 John Sangwon Lee, MD., FAAP

Picture 428. Common warts on fingers and hands Copyright ⓒ 2012 John Sangwon Lee, MD., FAAP

Picture 430. Common wart on the back of the hand Copyright ⓒ 2012 John Sangwon Lee, MD., FAAP

Picture 431. Common warts around fingers and nails Copyright ⓒ 2012 John Sangwon Lee, MD., FAAP Copyright ⓒ 2012 John Sangwon Lee, MD., FAAP

Picture 432. Common warts on fingers and hands Copyright ⓒ 2012 John Sangwon Lee, MD., FAAP

Picture 433. Normal wart around the nail Compared to Photo 429, there are similarities in shape. Copyright ⓒ 2012 John Sangwon Lee, MD., FAAP

Picture 434. Plantar wart on the sole of the foot Copyright ⓒ 2012 John Sangwon Lee, MD., FAAP

Picture 435. Common wart on the back of the hand Copyright ⓒ 2012 John Sangwon Lee, MD., FAAP

2. Flat warts/“juvenile warts”

• It can fly over the face, arms and legs.

• Warts can be small and multiple.

• The top of the wart is flat and not painful.

3. Filiform warts

• Common on the face and neck.

• The surface of the wart is thin and pointed like a thread.

4. Sexually transmitted warts (Anogenital warts/Condylomata acuminata)

• A cauliflower-shaped surface that matches the color of the surrounding skin;

• Several mm to several cm large

• Can fly on a man’s penis or scrotum, anus or around the anus.

• Can fly in a woman’s vulva, perianal, vaginal cavity, and cervix.

• It is usually not painful, but it may be itchy, burning, localized, and may bleed.

Apical condyloma (Condyloma/Human Papilloma/Human Papilloma/Human Papilloma Virus Infectious Disease/ Human papillomavirus infection/Condyloma acuminatum (HPV Infection)

■ Apical condyloma (condyloma/human papilloma/human papillomavirus infectious disease/human papillomavirus) Causes of Infectious Diseases/Human Papilloma Virus Infectious Diseases)

Picture 4-28. Photo of human papillomavirus viewed under an electron microscope. Source-Laboratory of tumor virus biology

Picture 4-29. Apical condyloma (condyloma) in female external genitalia

• Human papillomavirus (Human papillomavirus/HPV) infection of the internal and external genital organs can cause human papillomavirus genital warts.

• Human papillomavirus infection is also called human papillomavirus infection.

• Warts caused by infection of the external genital organs by the human papillomavirus are called acuminate condyloma, condyloma, or wet wart.

• Human papillomavirus infection can occur in the cervix, resulting in cervical human papilloma. This can lead to cervical cancer or cervical dysplasia.

• One or two or several wet warts (condyloma) on the external genitalia, vagina, or anus due to infection with the papillomavirus in the human papillomavirus condyloma that was in the external genitalia, cervix, or perianal area of ​​the sexual partner during sexual intercourse can fly in piles (see photo 429).

• Rarely, the human papillomavirus in the external genitalia of the parturition, especially in the vaginal birth canal (condyloma/wet wart), can infect babies or newborns at birth.

• Human papillomavirus infection is mainly transmitted through sexual intercourse.

• About 20 million Americans are infected with human papillomavirus, with 6.2 million new infections reported each year (Connecticut epidemiologist Vol 27 #2).

• Human papillomavirus (HPV) associated with cancer – vulvar cancer, vaginal cancer, cervical cancer, penile cancer, anal cancer, oropharyngeal cancer, tongue cancer, tonsil cancer, skin cancer, head squamous cell cancer, Neck squamous cell carcinoma can be caused by human papillomavirus infection. Source: Supplement to Preventive Medicine October 2011

• 11% of adolescent girls and young women aged 13 to 21 years of age have not had sexual intercourse and are already infected with the human papillomavirus (HPV), a study found. Source: Contemporary Pediatrics August 2012

■ Symptom signs of acuminate condyloma (condyloma/human papilloma/human papillomavirus infection/human papillomavirus infection/human papillomavirus infection)

• A wart that looks like the surface of cabbage and is the same color as the skin around it.

• Several millimeters to several centimeters in diameter.

• Can fly around the penis, scrotum and anus in men

• Can fly in a woman’s vulva, perianal, vaginal cavity, and cervix.

• Symptoms may include painless, itchy, burning, localized pain and bleeding.

• Sharp condylomas are also called anal genital warts.

• Acuminate condylomas (condylomas) are the size of a grain of rice and some are as large as the tip of an adult’s thumb.

• The color of acuminate condyloma may be similar to normal skin color or maybe a little redder than normal skin color.

• It does not hurt to touch.

• There are few symptomatic signs of acrosome condyloma caused by human papillomavirus infection other than the seemingly unsightly appearance.

• Apical condyloma is a type of viral sexually transmitted disease most commonly transmitted through sexual intercourse.

• Can be a major cause of cervical cancer in women and can be a major cause of abnormal Pap tests.

■ Vaccine Condyloma acuminatum (HPV Infection) Vaccine Recommended Basic Human Papillomavirus Vaccination Schedule for Children and Adolescents in the United States age prevention inoculation Vaccine type (Infectious diseases that prevent)

Immediately after birth 1 month after birth 2 months after birth 4 months after birth 6 months after birth 9 months after birth 12 months after birth 15 months after birth 18 months after birth 19-23 months from 2 to 3 years old from 4 to 6 years old after 7 years old 10 years old 11-12 years old 13-15 years old 16-18 years old (Human papillomavirus¹² (HPV2; for women only (HPV4; ​​for women and men) Human papillomavirus infectious disease ←Three doses inoculation→

• Human papillomavirus infectious disease vaccine includes HPV2, which contains human papillomavirus types 16 and 18, and is used when vaccinated to girls and adult women.

• The other is HPV4, which contains human papillomavirus types 6 and 11 components, and this vaccine is used when vaccinated to male or adult males. Source: AAP News December 2009

The CDC is concerned about the low rates of human papillomavirus (HPV) vaccination among US girls.

Parents who are reluctant to vaccinate their children with HPV vaccine because they are concerned about the safety of getting vaccinated against HPV and mistakenly believe that it will open the door to more casual sex after getting vaccinated. have. In addition, due to the cost of getting vaccinated, they may not give you the recommended vaccination.

Because HPV vaccination reduces the incidence of uterine cancer, most parents try to proactively vaccinate their children with HPV vaccination as recommended.

According to the CDC, only about 54% of adolescent girls in the United States have had at least one HPV vaccine. It is recommended that HPV vaccination should be more aggressively administered in the future as recommended. Source: The Journal of the American Medical Association (JAMA) July 26, 2013

Persistent anogenital human papillomavirus infection In particular, it causes dysplastic lesions in the female external genitalia, such as the cervix and vaginal cavity. It can later cause cancer of the cervix, vaginal cavity, vulva in women and vulva, anus, and oropharynx in men. Diagnosed with a pep test.

The effect of two doses of human papillomavirus quadrivalent vaccine (Gardasil) for adolescent girls aged 9 to 13 years is almost the same as that for women aged 16 to 26 years. Study: Vaccine may offer the same HPV protection at fewer doses. Source: The Journal of the American Medical Association JAMA May 1 2013

Cervarix (human papillomavirus vaccine Types 16, 18 can prevent cervical cancer as well as throat cancers. Vaccination with Cervarix can prevent cervical cancer caused by human papillomavirus (HPV) infection, as well as pharyngeal and throat cancer. Source: The Journal of the American Medical Association (JAMA) Friday, July 19, 2013

 

5. Persistent perianal human papillomavirus infection

• May be present in a woman’s reproductive organs, such as a woman’s cervix and vaginal cavity.

• Abnormal cells may be found in the results of the Pap test.

• A biopsy may reveal tumor cells.

• The same biopsy results may appear in other areas of the genital organs and in the anal mucosa.

• These neoplastic changes may also appear in the cervix, vagina, genitals, penis, anus, mouth, and pharynx.

6. Juvenile recurrent respiratory papillomatosis

• Recurrent papillitis of the upper respiratory tract or larynx.

• It usually occurs in children aged 2-3 years, and with this disease, voice changes, abnormalities, and stenosis may occur.

• As the disease progresses, the lower respiratory tract may be blocked.

7. Epidermodysplasia verruciformis/EV)

• It is a rare disease. It is a chronic skin human papillomavirus infection.

• This disease can develop into skin cancer.

■ Incubation period

• Not sure.

• Depends on the type of human papillomavirus infection. • About 3 months to as long as 10 years.

■ Diagnosis

• For most skin types, human papillomavirus infectious disease, that is, warts, is diagnosed by combining the history, symptoms, signs, and examination findings. • Respiratory papillomas are diagnosed by endoscopy and biopsy.

• Dysplasia caused by cervical papillomavirus infection is diagnosed by biopsy.

• It can be diagnosed by virus detection and can be diagnosed by Cervista HPV HR test.

• It is not diagnosed by a serological test.

■ treatment

• Anogenital warts can go away naturally within a few months.

• If it does not go away naturally, it is treated with chemical treatment, physical treatment, salicylic acid solution, nitrogen solution, surgical treatment, laser treatment, and medications such as Tretinoin or Cimetidine.

■ Prevention

• The 9-valent human papillomavirus vaccine (9-valent HPV/9 v HPV) is said to be 100% effective. Pediatrics, 12/2019

The 4v HPV and 2v HPV vaccines are also said to be effective.

출처 및 참조 문헌 Sources and references

• NelsonTextbook of Pediatrics 22ND Ed
• The Harriet Lane Handbook 22ND Ed
• Growth and development of the children
• Red Book 32^nd Ed 2021-2024
• Neonatal Resuscitation, American Academy Pediatrics

•  Safety of the 9-Valent human papillomavirus vaccine. Pediatrics, 12/2019
• Red Book 29-30th-31st Edition, American Academy of Pediatrics
• Harriet Lane Handbook 19th ed
• Nelson Pediatric Textbook 19th-21st ed.
• MMWR
• CDC
• 그 외

Copyright ⓒ 2014 John Sangwon Lee, MD ., FAAP

“부모도 반의사가 되어야 한다”-본 사이트의 내용은 여러분들의 의사로부터 얻은 정보와 진료를 대신할 수 없습니다.

“The information contained in this publication should not be used as a substitute for the medical care and advice of your doctor. There may be variations in treatment that your doctor may recommend based on individual facts and circumstances.

“Parental education is the best medicine.”