Condyloma acuminatum general treatment
Western medicine treatment of condyloma acuminatum. Since there are no special antiviral drugs, the treatment of condyloma acuminatum must be treated comprehensively.
(1) Treatment incentives: excessive leucorrhea, excessively long foreskin, and gonorrhea.
(2) Improve body immunity.
(3) Application of anti-disease drugs. Generally, as long as the rules of comprehensive treatment can be cured.
Surgical treatment of genital warts
For single, small area of genital warts, it can be surgically removed; for huge condyloma acuminatum, Mohs’ surgery can be used to remove, and the frozen section is used to check whether the damage is removed.
The use of liquid nitrogen at a low temperature of -196 ℃, the use of freezing method to treat condyloma acuminatum, promote the wart tissue necrosis and shedding, this method is suitable for a small number of small areas of genital warts, 1-2 treatments are possible, the interval is one week.
3. Laser treatment
CO2 laser is usually used to treat condyloma acuminatum by cauterization. This therapy is most suitable for genital warts on the vulva, penis or perianal. One-time treatment is possible for single or a small number of multiple genital warts, 2-3 times for multiple or large areas of genital warts, the interval is generally one week.
4. Electrocautery treatment
Use high-frequency electroacupuncture or electrocautery to remove condyloma. Method: Local anesthesia, then electrocautery, this therapy is suitable for a small number and small area of genital warts.
5. Microwave therapy
Using a microwave surgical treatment machine and lidocaine for local anesthesia, insert the tip of the rod-shaped radiation probe into the sharp wetness and reach the base of the wart body. When it is seen, the body becomes smaller, the color becomes darker, and the soft radiation becomes hard. The probe can be pulled out. Solidified lesions can be removed with tweezers. In order to prevent recurrence, the remaining base can be repeatedly solidified once.
6. Beta-ray therapy
We applied β-rays to treat condyloma acuminatum and achieved satisfactory results. This method has high curative effect, no pain, no damage, few side effects, low recurrence rate, and has clinical promotion value.
7. Drug therapy
(1) Potentilla oil:
This treatment is suitable for genital warts in wet areas, such as genital warts that occur on the glans and perineum where the foreskin is too long for circumcision. But for cervical condyloma acuminatum can not be treated with podophyllin. Apply 20% podophyllum lipid tincture to the skin lesion or before applying the medicine, firstly use an oily antibacterial ointment to protect the normal skin or mucous membrane around the skin lesion, and then apply the medicine, and use 30% boric acid water or 4-6 hours after use Wash with soapy water and re-use the medicine after 3 days if necessary. This medicine is the first medicine used in the treatment of this disease abroad, and it is usually cured once. However, there are many shortcomings, such as large destructive tissue, improper use can cause local ulcers. High toxicity, mainly manifested as nausea, intestinal obstruction, leukopenia and thrombocytopenia, tachycardia, urinary closure or oliguria, so use must be cautious, when the above reaction is found, the drug should be stopped immediately.
(2) Antiviral drugs:
Available with 5% phthalamide cream, or 0.25% herpes net ointment, 2 times a day, applied externally. Acyclovir is taken orally 5 times a day, 200 mg each time, or its ointment for external use, 3 million units of α-interferon are injected daily, and the drug is administered five days a week. Or 3 million units of interferon are injected into the base of the wart body twice a week. After continuous use for 2-3 weeks, the main side effect is influenza-like syndrome, and the side effects of topical medication are few and slight.
(3) Corrosive agent or disinfectant:
Commonly used are 30% -50% trichloroacetic acid or saturated dichloroacetic acid, or 18% peroxyacetic acid. Use 10% salicylic acid glacial acetic acid or 40% formaldehyde, 2% liquefied phenol, 75% ethanol distilled water 100ml mixed solution, spot application, for glans, perianal warts, once a day or every other day, the effect is very good. Disinfectant can be applied externally with 20% iodine tincture, or 2.5-5% iodine tincture is injected at the base of the wart body, 0.1-1.5ml each time, or externally applied with Xin Jie Er Jie or 0.1-0.2%, the latter needs to be combined with systemic therapy.
(4) Anticancer drugs
① 5-fluorouracil (5-F u):
Generally 5% ointment or cream for external use, 2 times a day, 3 weeks as a course of treatment. 2.5% ~ 5% fluorouracil wet compress is used to treat penile and perianal condyloma acuminatum, every 20 minutes, once a day, 6 times as a course of treatment. Polyethylene glycol can also be used as a matrix, and 5-Fu powder, which accounts for 5% of its dry matter, can be used as a suppository to treat condyloma acuminatum in male and female urethra. 5-Fu base injection can also be used.
Mainly used for condyloma acuminatum in urethra that failed 5-F u treatment. Suppositories (each containing 15mg) are used daily for 8 days. 60mg of this product can also be added to 10-15ml of sterile water and instilled into the urethra weekly , Keep for half an hour, side effects have urethritis. It can also be used to soak the affected area with 10mg of this product and 10ml of it three times a day for half an hour each time to treat penile and glans coronal genital warts. It is mainly used for other patients who have residual warts or relapse after treatment. You can also dilute this solution twice and soak it locally to prevent recurrence.
It can be applied externally with 2-8% physiological saline solution, applied twice, with 72-hour intervals to treat penile genital warts. Superficial erosion may occur after application.
④ Streptozotocin or Pingyangmycin:
Use 0.1% physiological saline solution for intradermal lesion injection, the total amount of each time is limited to 1 ml (1 mg), most of them can be cured at one time. Pingyangmycin is a replacement product of streptozotocin, and its usage is basically the same. It can also be injected with pingyangmycin 10 mg dissolved in 10% procaine in 20 ml.
① Autologous vaccine method:
The patient’s own wart tissue homogenate (thaw cold inactivated virus), and heat treatment (56 ℃ one hour) to collect supernatant injection, can be used for intractable perianal warts.
② Interferon inducer:
Polymyosine and tirolone are available. Polymyosin was injected 2 ml daily for 10 days, and the drug was continued after 1-2 months of withdrawal. Tirolone 3 times a day, 300 mg each time, discontinued for 4 days, or 600 mg orally every other day.
③ Interferon, interleukin Ⅱ, bacillin,
The combined application of Rebecca has better curative effect.
9. Selection of treatment methods:
① Medium and small size warts (external wart body diameter <0.5 cm, wart body mass diameter <1 cm, wart body number <15) that can be seen in the external genital area of male and female sexes, generally treated with external medicine.
②In men’s urethra and perianal, women’s vestibule, urethra, vaginal wall and cervical wart; or men and women with warts whose size and number exceed the above standards, physical treatment is recommended.
③After physical therapy treatment, when there are still a few residual warts, external medicine can be used for treatment.
④Whether it is drug therapy or physical therapy, an acetate white test must be done to try to remove the damage including subclinical infection to reduce recurrence.
⑤Treatment of condyloma acuminatum in pregnant wome
n: should be treated as early as possible in pregnancy; those who still have skin lesions near delivery, such as obstructing the birth canal, or vaginal delivery will cause severe bleeding, you should consider cesarean section; podophyllotoxin (footpod ), Podophyllin and fluorouracil have teratogenic effects and are contraindicated in pregnant women; the safety of imiquimod for pregnant women has not been determined. Pregnant women can choose 50% trichloroacetic acid solution for external use, laser treatment, cryotherapy or surgical treatment. Condyloma acuminatum is not an indicator of termination of pregnancy. When the wart is large, blocking the birth canal or causing severe bleeding, cesarean section should be considered.
10. Matters needing attention
(1) Natural return form:
Dissolve on its own, remain unchanged, and increase in size and number. Some patients can heal without any treatment.
(2) The current treatment of condyloma acuminatum can reduce infectivity,
But it may not eradicate its infectivity.
(3) Choose the right treatment
The appropriate treatment method should be selected according to the patient’s condition and the resources available and the experience of the physician.
(4) Patients often have other infections,
Necessary examinations should be performed before treatment. When inflammation or other infections are locally incorporated, other infections and inflammations should be controlled first to avoid spreading of the lesions after treatment.
(5) Follow-up should be carried out after treatment,
Regardless of the treatment plan, once the wart is removed, it should be kept locally clean and dry to promote wound healing. Topical antibiotic ointment can be used topically, and oral antibiotics can be taken if necessary to prevent secondary bacterial infections.
The prognosis of condyloma acuminatum is generally good. Although the recurrence rate is high after treatment, it can be clinically cured by correct treatment.