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Category: Venereology

Warts (verrucae)

Venereology
Warts (verrucae)
What are warts?

Warts (or verrucae) are a viral skin infection that affects the outer layer of the skin and is caused by strains of the human papillomavirus (HPV). Warts are a very common dermatological issue. This virus is highly contagious and can remain in a latent state in some individuals, meaning it causes no visible symptoms.
Although warts are benign, they can cause problems depending on their location.

Warts can appear in people of all ages, but they are more commonly seen in childhood, particularly between the ages of 12 and 16.

Warts (verrucae)
Everything you need to know
1
What causes warts?

The HPV virus enters the body through direct contact—usually via a minor injury or a small crack in the skin—and triggers the proliferation of skin cells, resulting in the formation of benign skin overgrowths, known as warts.

2
Where do warts appear and how are they transmitted?

Warts most commonly appear on the hands and soles of the feet, while the face and other parts of the body are affected less frequently.

Plantar warts (on the soles) often cause pain and may be mistakenly identified as corns or calluses. Warts are transmitted through direct skin contact with a lesion, either from another person or through autoinoculation—when the lesion comes into contact with another area of the patient’s own skin.

3
Clinical presentation of warts.

The clinical presentation of warts consists of nodules with an irregular surface. More specifically, they are flesh-colored papules measuring approximately 2–5 millimeters in diameter, which evolve into dome-shaped, hyperkeratotic growths. Their color usually ranges from gray to brown.
Black dots can be seen on the surface of the lesions, which correspond to thrombosed blood vessels. The lesions are typically solitary, but in some cases, multiple warts may appear together. Finally, if they develop in an area that has been injured, they may appear in a linear arrangement.

4
Clinical types of warts.

There are three types of warts:

1. Common warts are exophytic lesions and are typically found on the dorsal surfaces of the hands, fingers, around the nails, elbows, and knees.

2. Plantar warts are endophytic lesions (due to the pressure from body weight) and appear on the soles of the feet. They are painful when walking and are often mistaken for corns (calluses).

3. Flat warts appear as asymptomatic, numerous lesions, mainly on the face.

5
Methods of wart treatment

The treating dermatologist will make the diagnosis following a clinical examination and will determine the appropriate treatment method based on each patient’s individual case.

Treatment options for warts include CO₂ laser, Pulsed-Dye Laser, cryotherapy with liquid nitrogen, and electrocautery.

In addition to these methods, topical treatment can also be done at home using solutions containing salicylic acid or lactic acid, though special care must be taken when using them.

The course of warts is not easily predictable, and even after treatment, there is a possibility of recurrence requiring further management.

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To avoid contracting warts, it is important to follow basic hygiene rules. Specifically:

  • Wash your hands frequently and thoroughly

  • Avoid letting your bare feet come into contact with sand or the areas around swimming pools

  • Use only your own personal hygiene items (e.g., towels)

 
 
 
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Chlamydia

VenereologyVENEREOLOGY
Chlamydia
What is chlamydia infection and what causes it?

Chlamydial infections are sexually transmitted infections caused by the bacterium Chlamydia trachomatis.
The name derives from the ancient Greek word “chlamys” (meaning “cloak” or “mantle”) due to its shape, as it resembles a cloak surrounding the nucleus of the infected cell.
These infections tend to affect young individuals more frequently, particularly those with an active sexual life and multiple partners.
Although chlamydial infections can be treated with antimicrobial therapy, many cases remain undiagnosed due to the high percentage of asymptomatic patients (70% of women and over 50% of men).

CHLAMYDIA
Everything you need to know
1
How is chlamydia infection transmitted and what can it cause in the human body?

Chlamydia infection is transmitted through sexual contact (oral, vaginal, anal) when one person is a carrier of the bacteria. Also, a mother infected with chlamydia can transmit it to the fetus during normal childbirth.

Chlamydia in women causes cervicitis, salpingitis, urinary tract infection, infection of the inside of the uterus and often infection of the entire inside of the lower abdomen (pelvic infection). In men, it causes urethritis and can spread to the testicles. In fact, if not diagnosed early, it can cause prostatitis, or even sterilization.

2
Clinical picture and symptoms of chlamydial infection

More than 70% of women and 50% of men with chlamydia infection do not have symptoms when they are infected. Infection in the anus and throat usually does not have symptoms.

The most common symptoms in women are:

  • change in the color or odor or amount of vaginal discharge
  • bleeding between periods or heavier periods
  • bleeding after sex
  • burning sensation during urination
  • pain or discomfort in the lower abdomen.

 

The most common symptoms in men are:

  • burning sensation during urination
  • urethral discharge
  • pain or discomfort in the testicles.
3
How is chlamydia infection diagnosed and treated?

To diagnose a chlamydial infection, laboratory testing is necessary using a sample from the genital area. In some cases, a urine test may also be helpful.

If you believe you have been in contact with someone infected with chlamydia or other infections, or if you are experiencing symptoms that may be related to chlamydial infection, you should consult your dermatologist–venereologist. Chlamydial infection is treatable with antibiotic therapy. However, it should be noted that if left untreated, the infection can lead to serious complications in the human body.

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You should avoid all types of sexual contact, even with the use of a condom, until both you and your partner have completed treatment and your symptoms have disappeared.

If you have been diagnosed with chlamydia infection, it is important to inform your current partner, as well as all partners in the last 2 months, so that they can be tested and receive appropriate treatment. This will help prevent you from becoming reinfected, and your partners from developing complications of the disease.

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Infectious termite

Venereology
Infectious termite
What is Infectious Termite?

Molluscum contagiosum is a benign viral disease of the skin and mucous membranes.
It is caused by the molluscum contagiosum virus (MCV).
The virus produces a substance that affects the infected cells and causes their uncontrolled proliferation, resulting in visible clinical lesions.
It can also be transmitted through sexual contact, affecting the genital organs and the skin of the perigenital area.

Everything you need to know
1
Clinical picture and diagnosis of the disease

These are visible, dome-shaped, round papules that are flesh-colored or slightly pink, measuring 2 to 5 millimeters in diameter, with a characteristic central umbilication. The lesions begin as small, skin-colored bumps with a soft texture and later increase in size, become firmer, are not easily ruptured, and contain a solid white core. They usually appear in clusters but can also be solitary.

The incubation period of the disease ranges from 14 days to up to 6 months. The condition often resolves spontaneously within 6 to 9 months, but it may persist for 3 to 4 years. Diagnosis is primarily clinical and is based on the identification of the characteristic umbilicated lesions. In the case of a solitary lesion, differential diagnosis should be made from pyogenic granuloma, keratoacanthoma, and squamous cell carcinoma.

2
Types

The infective termite includes four types

  • Type 1 (MCV-1) mainly affects children
  • Type 2 (MCV-2) in adults
  • Types 3 and 4 rarely cause infection

The last two types are due to transmission through sexual contact.

3
Causes of the disease

The disease is highly contagious and spreads by self-inoculation at points of skin breakdown or after direct contact with skin lesions.

In addition, it can be transmitted through the shared use of clothing, towels and personal equipment in various sports. Itching and scratching the affected area contributes to the spread and multiplication of the lesions.

4
Treatment of the disease

The treatment of choice for the disease is mechanical excision of the lesions using surgical forceps.

Other alternative treatment methods include:

  • cryotherapy,

  • laser (CO2, Pulse Dye) and

  • photodynamic therapy.

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The fact that you have recovered from molluscum contagiosum does not mean that you have developed immunity to the virus.
There is a possibility of becoming infected again.
Moreover, molluscum contagiosum is not one of the viruses that remain dormant in the body after treatment in a latent state, such as the herpes virus.
If you have been treated and symptoms reappear, it means that you have been reinfected.

Sometimes, molluscum contagiosum is self-limiting and resolves without treatment.
Nevertheless, it is essential to visit a dermatologist and monitor the lesions, because if they increase in size, treatment becomes more time-consuming and the risk of scarring increases.

Laser removal of the lesions is considered a first-line treatment, as it is safe, targeted, and effective.
Specifically, the laser beam targets only the lesion (without affecting the surrounding skin), helping to prevent injury, scarring, and marks.
Once a thorough dermoscopic examination has been performed to detect and locate all lesions, the laser enables their removal, ensuring the effectiveness of the treatment and the complete elimination of all lesions.
Finally, the treated area heals quickly, leaving the skin aesthetically intact.
However, it should be noted that it is the treating dermatologist who will determine the most appropriate treatment approach for each individual case.

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Genital herpes

Venereology
Genital herpes
What is genital herpes?

Genital herpes infection is a sexually transmitted disease. It is a viral infection caused by the herpes simplex virus (HSV), primarily by HSV-2 and to a lesser extent by HSV-1.
Herpes simplex virus type 1 (HSV-1) usually causes oral herpes (cold sores), while type 2 (HSV-2) is mainly responsible for genital herpes.
However, HSV-1 can also cause genital herpes through oral-genital contact (oral sex).
It is the most common cause of sexually transmitted ulcers worldwide.
Finally, infection with HSV-2 increases the risk of HIV infection and transmission by 2–3 times, even after the healing of HSV-2-related ulcers and erosions.

Genital herpes
Everything you need to know
1
What are the symptoms, clinical presentation, and recurrence pattern of genital herpes?

It can affect the skin and mucous membranes and occurs in both sexes. Symptoms tend to appear more frequently in women. Genital herpes can present in various clinical forms and with differing severity, or may even cause no symptoms at all (asymptomatic infection).
The infection is lifelong, with intermittent clinical and subclinical reactivation of the virus and shedding from mucosal or skin surfaces. Some individuals carry the virus without showing any visible clinical lesions.

However, the typical clinical picture of the primary infection appears a few days (usually 3–7 days) after the initial exposure to the virus. Once the virus enters the body, it begins to replicate in the cells of the epidermis or mucous membranes, causing temporary cell destruction. This manifests as erythematous papules and vesicles filled with serous or seropurulent fluid, redness, and swelling of the affected area.
Over the next few days, the roofs of the vesicles rupture, leaving erosions and ulcers that heal slowly, with the possibility of new lesions appearing for up to 2–3 weeks.

Some systemic symptoms caused by herpes infection include:

  • Fever, chills, fatigue, myalgia, lower back pain

  • Lymphadenopathy in the lymph nodes draining the affected area

  • Pain, discomfort, burning or tingling sensation, itching

  • In women, dysuria (painful urination), vaginal pain, and vaginal discharge are often observed

Subsequently, through peripheral sensory nerves, the virus begins its journey within the body, ultimately reaching the sensory ganglia, where it remains for life in a latent state. Upon reactivation, it migrates in reverse from the sensory ganglion to the surface of the mucosa or skin within the corresponding dermatome, where it replicates and is shed through secretions or cellular apoptosis.
Triggers for reactivation may include infection, trauma, stress, UV radiation exposure, menstruation, immunosuppression of any cause, or it may occur spontaneously without any known predisposing factor. Most recurrences do not result in a clinical episode, as they are contained by cellular immunity.

2
Where are the clinical lesions of the virus located?

In women, the lesions most commonly occur inside the vagina, as well as externally on the labia minora and majora. In men, they are located along the penis and in the scrotum area. Lesions can be seen in both sexes on the thighs, buttocks, and around the anus.

3
Diagnosis of genital herpes virus

Its diagnosis is based mainly on a detailed medical history, clinical examination and detection of the characteristic lesions of the disease, which is accompanied by special laboratory testing.

To determine which virus has caused the skin lesions on the genitals, a special blood test is performed, which includes molecular and immunological testing (herpes antibodies and herpesvirus molecular testing).

4
Therapeutic treatment of genital herpes virus

The treatment of the primary infection and subsequent episodes includes antiviral agents and analgesic therapy to relieve the symptoms of the disease. However, unfortunately, these treatments cannot eradicate the virus, which remains in the body permanently. In cases of frequent recurrences, suppressive therapy may be administered. Modern pharmacological treatment, when administered properly, reduces the duration of each episode, prevents recurrences, and limits the transmission of genital herpes. Finally, consistent use of condoms—even between recurrences—reduces the risk of transmission.

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A first episode (i.e. a new infection) of genital herpes during pregnancy can have serious effects on the fetus if left untreated. However, a recurrence of old genital herpes usually does not cause problems for the fetus. The mother will normally receive treatment as if she were not pregnant.

  • Avoid touching the sore with bare hands, as the virus can be transferred to another location—for example, from the mouth to the fingers, nose, or eyes.
  • Regular and thorough hand washing is recommended.
  • Sexual intercourse is strictly prohibited when visible lesions are present, and in any case, the use of condoms is strongly advised.
  • To prevent herpes recurrences during the summer, the use of sunscreen with a high protection factor is recommended.

No, the virus does not survive long outside the body; therefore, genital herpes is transmitted only through sexual contact, the exchange of bodily fluids, and direct skin-to-skin contact with the lesion.

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