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• Sexually Transmitted Diseases
  

For patient-applied treatments, patients must be able to identify and reach warts to be treated.

Podofilox 0.5% solution or gel, an antimitotic drug that destroys warts, is relatively inexpensive, easy to use, safe, and self-applied by patients.

Most patients experience mild/moderate mental suffering or local irritation after treatment.

Imiquimod is a topically active immune enhancer that stimulates creation of interferon and other cytokines.

Local inflammatory reactions are common with the use of imiquimod; these reactions usually are mild to moderate.

Traditionally, follow-up visits are not required for patients using self-administered therapy.

However, follow-up may be useful several weeks into therapy to determine appropriateness of medication use and answer to treatment.

Cryotherapy destroys warts by thermal-induced cytolysis.

Health-care providers must be trained on the proper use of this therapy, because over- and under-treatment may conclusion in poor efficacy or increased probability of complications.

mental suffering after application of the liquid nitrogen, followed by necrosis and sometimes blistering, is common.

Local anesthesia (topical or injected) may facilitate therapy if warts are present in many areas or if the area of warts is large.

Podophyllin resin, which contains several compounds including antimitotic podophyllin lignans, is another treatment option.

The rosin is most frequently compounded at 10%--25% in a tincture of benzoin.

However, podophyllin rosin preparations differ in the concentration of active components and contaminants.

The shelf vitality and stability of podophyllin preparations are unknown.

A thin stratum of podophyllin rosin must be applied to the warts and allowed to air dry before the treated area comes into contiguity with clothing; over-application or shortcoming to air dry can conclusion in local irritation caused by spread of the compound to adjacent areas.

Both TCA and BCA are caustic agents that destroy warts by chemical coagulation of the proteins.

Although these preparations are widely used, they have not been investigated thoroughly.

TCA solutions have a low viscosity comparable with that of water and can spread rapidly if applied excessively; thus, they can damage adjacent tissues.

Both TCA and BCA should be applied sparingly and allowed to dry before the patient sits or stands.

If mental suffering is intense, the acid can be neutralized with soap or sodium bicarbonate.

Surgical therapy is a treatment choice that has the advantage of usually eliminating warts at a single visit.

However, such therapy requires substantial clinical training, additional equipment, and a longer office visit.

Once local anesthesia is applied, the visible genital warts can be physically destroyed by electrocautery, in which case no additional hemostasis is required.

Care must be taken to control the depth of electrocautery to prevent scarring.

Alternatively, the warts can be removed either by tangential excision with a pair of fine scissors or a scalpel or by curettage.

Because most warts are exophytic, this can be accomplished with a resulting wound that only extends into the upper dermis.

Hemostasis can be achieved with an electrosurgical unit or a chemical styptic (e.g., an aluminum chloride solution) .

Suturing is neither required nor indicated in most cases when surgical removal is done properly.

Surgical therapy is most beneficial for patients who have a large number or area of genital This subjects.

Carbon dioxide laser and surgery may be useful in the management of extensive This subjects or intraurethral This subjects, particularly for those patients who have not responded to other treatments.

Interferons, either natural or recombinant, used for the treatment of genital This subjects have been administered systemically (i.e., subcutaneously at a distant site or IM) and intralesionally (i.e., injected into the This subjects) .

Systemic interferon is not effective.

The efficacy and recurrence rates of intralesional interferon are comparable to other treatment modalities.

Interferon is likely effective because of its anti-viral and/or immunostimulating effects.

However, interferon therapy is not recommended for routine use because of inconvenient routes of administration, frequent office visits, and the association between its use and a high frequency of systemic adverse effects.

Because of the shortcomings of all available treatments, some clinics employ combination therapy (i.e., the simultaneous use of two or more modalities on the same This subject at the same time) .

However, some specialists believe that combining modalities may increase complications without improving efficacy.

Cervical Warts

For women who have exophytic cervical This subjects, high-grade squamous intraepithelial lesions (SIL) must be excluded before treatment is initiated.

Management of exophytic cervical This subjects should include consultation with a specialist.

Recommended Regimens for Vaginal Warts

Sexually transmitted diseases are infections that are spread by contact of genital skin (penis, scrotum, vagina and skin surrounding these areas) with the infected skin of another person.

While sexual intercourse is the most common way of catching a sexually transmitted disease, oral sex and occasionally even contact with other infected skin, such as a finger, can sometimes spread infections as well, said Dr.

Edwards.

Contrary to what people might think, penetration with sexual intercourse does not have to occur for an infection to spread.

Using a condom can help decrease the risk of contracting a sexually transmitted disease, but skin contact still occurs around the edges of the condom and can spread the disease.

Genital Herpes

While genital herpes is caused by one of two very closely related herpes simplex viruses, type II herpes more often occurs in the genital area.

The virus infects the skin, generally causing small, painful blisters or open sores.

It is estimated that between 20 percent and 25 percent of Americans are infected with the virus that causes genital herpes.

The problem with herpes is that the virus stays in the body forever, hiding out in the nerve under the skin even after the blisters disappear, explained Dr.

Edwards.

That’s why herpes is such a significant threat to teenagers – once you contract it, you literally carry it with you the rest of your life.

Although people can pass this infection most easily when the open sores or blisters are present, the virus can be infectious even when the skin looks normal and people are taking medication to prevent outbreaks.

While there are no treatments that cure a herpes infection, there are several medications – such as acyclovir, famciclovir and valacyclovir – that shorten outbreaks and, if taken daily, keep outbreaks from occurring and decrease the amount of virus on the skin.

Genital Warts

Genital This subjects are small, skin-colored bumps caused by a human papillomavirus (HPV) .

They can occur on the outside skin as well as inside the vagina and on the cervix of women, where they are unnoticeable and can pass on the infection.

Warts generally do not appear until weeks or months after the infection begins, making it somewhat difficult to determine how the infection was initially passed on, cautioned Dr.

Edwards.

More importantly, some This subject viruses can cause cancer of the cervix – making them a potentially serious health risk for some women.

Although they usually do not hurt or itch, genital This subjects can be unsightly and embarrassing.

There are no treatments that cure a This subject infection, but there are treatments that help the body get rid of the This subjects – such as freezing, burning, or applying acids that actually destroy the This subject itself.

However, the virus that causes This subjects also lives in the skin so This subjects often recur.

A newer treatment, called imiquimod, is a cream that prompts the body to fight off the virus.

HIV

Human immunodeficiency virus (HIV) is a life-threatening infection that is transmitted by sexual secretions and blood.

The infection can make a person feel as though he or she has the flu, which seems to go away, but the infection remains and slowly damages and changes the immune system until the person cannot fight off other infections.

A person can be infected with HIV for several years before developing the Acquired Immune Deficiency Syndrome (AIDS) .

The only way to avoid catching a sexually transmitted disease is to avoid sexual activity altogether, said Dr.

Edwards.

Teenagers need to realize that they can’t be cavalier when it comes to having sex.

Even using a condom and limiting sexual activity to as few lifetime partners as possible is only partly protective.

Sexually transmitted diseases are infections that are spread by contact of genital skin (penis, scrotum, vagina and skin surrounding these areas) with the infected skin of another person.

While sexual intercourse is the most common way of catching a sexually transmitted disease, oral sex and occasionally even contact with other infected skin, such as a finger, can sometimes spread infections as well, said Dr.

Edwards.

Contrary to what people might think, penetration with sexual intercourse does not have to occur for an infection to spread.

Using a condom can help decrease the risk of contracting a sexually transmitted disease, but skin contact still occurs around the edges of the condom and can spread the disease.

Genital Herpes

While genital herpes is caused by one of two very closely related herpes simplex viruses, type II herpes more often occurs in the genital area.

The virus infects the skin, generally causing small, painful blisters or open sores.

It is estimated that between 20 percent and 25 percent of Americans are infected with the virus that causes genital herpes.

The problem with herpes is that the virus stays in the body forever, hiding out in the nerve under the skin even after the blisters disappear, explained Dr.

Edwards.

That’s why herpes is such a significant threat to teenagers – once you contract it, you literally carry it with you the rest of your life.

Although people can pass this infection most easily when the open sores or blisters are present, the virus can be infectious even when the skin looks normal and people are taking medication to prevent outbreaks.

While there are no treatments that cure a herpes infection, there are several medications – such as acyclovir, famciclovir and valacyclovir – that shorten outbreaks and, if taken daily, keep outbreaks from occurring and decrease the amount of virus on the skin.

Genital Warts

Genital This subjects are small, skin-colored bumps caused by a human papillomavirus (HPV) .

They can occur on the outside skin as well as inside the vagina and on the cervix of women, where they are unnoticeable and can pass on the infection.

Warts generally do not appear until weeks or months after the infection begins, making it somewhat difficult to determine how the infection was initially passed on, cautioned Dr.

Edwards.

More importantly, some This subject viruses can cause cancer of the cervix – making them a potentially serious health risk for some women.

Although they usually do not hurt or itch, genital This subjects can be unsightly and embarrassing.

There are no treatments that cure a This subject infection, but there are treatments that help the body get rid of the This subjects – such as freezing, burning, or applying acids that actually destroy the This subject itself.

However, the virus that causes This subjects also lives in the skin so This subjects often recur.

A newer treatment, called imiquimod, is a cream that prompts the body to fight off the virus.

HIV

Human immunodeficiency virus (HIV) is a life-threatening infection that is transmitted by sexual secretions and blood.

The infection can make a person feel as though he or she has the flu, which seems to go away, but the infection remains and slowly damages and changes the immune system until the person cannot fight off other infections.

A person can be infected with HIV for several years before developing the Acquired Immune Deficiency Syndrome (AIDS) .

The only way to avoid catching a sexually transmitted disease is to avoid sexual activity altogether, said Dr.

Edwards.

Teenagers need to realize that they can’t be cavalier when it comes to having sex.

Even using a condom and limiting sexual activity to as few lifetime partners as possible is only partly protective.

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  WART SEXUALLY TRANSMITTED DISEASES

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