Papillomaviruses and Warts: Diagnosis and Treatment
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Questions and Answers

What is the characteristic of koilocytes in papillomavirus infections?

  • They are dead keratinocytes.
  • They are small keratinocytes.
  • They are enlarged keratinocytes. (correct)
  • They are immature keratinocytes.
  • Where does viral production occur in papillomavirus infections?

  • Basal layers
  • Superficial layers (correct)
  • All layers of the skin
  • Intermediate layers
  • How does HPV infection evade the immune system?

  • It produces a protein that suppresses the immune system.
  • It is not affected by the immune system.
  • It hides from the immune system. (correct)
  • It produces a protein that stimulates the immune system.
  • What is the primary mode of transmission of HPV?

    <p>All of the above.</p> Signup and view all the answers

    What is the estimated prevalence of HPV infection in the United States?

    <p>At least 20 million Americans infected.</p> Signup and view all the answers

    Which HPV types are associated with cervical cancer?

    <p>HPV-16 and HPV-18.</p> Signup and view all the answers

    What is the characteristic of common warts caused by HPV?

    <p>They are benign and self-limited.</p> Signup and view all the answers

    What is the characteristic of oral papillomas caused by HPV?

    <p>They are pedunculated and have a rough surface.</p> Signup and view all the answers

    What is the risk factor for HPV infection and cancer progression?

    <p>All of the above.</p> Signup and view all the answers

    What is the estimated percentage of cervical cancers associated with HPV?

    <p>99.7%.</p> Signup and view all the answers

    Study Notes

    Papillomaviruses

    • There are over 100 types of papillomaviruses, classified into 16 groups (A to P) based on tissue specificity
    • Cutaneous HPV and mucosal HPV are two types, with a group of mucosal HPV being oncogenic
    • Papillomaviruses have a capsid with 72 capsomeres, arranged in an icosadeltahedron
    • Replication cycle is linked to keratinocytes and other epithelial cells, accessing cells in basal layers through breaks in superficial layers

    Characteristics of Papillomaviruses

    • Stimulate cell growth, which facilitates viral replication
    • Different nuclear factors induce transcription of viral genes (viral maturation) in the stratum granulosum
    • Virus is produced in stratum granulosum and released in stratum corneum (outermost layer)

    Pathogenesis and Transmission

    • Infection of skin epithelium → Warts
    • Infection of mucosae (oral, genital, conjunctivae) → Papilloma
    • Mode of transmission: close (direct) contact, fomites, and vertical transmission (mother-baby)
    • Prevalence and incidence: possibly the most common sexually transmitted infection (STI) worldwide

    Epidemiology

    • At least 20 million Americans infected and around 6 million new genital cases per year
    • Identified in 99.7% of all cervical cancers (HPV16 and HPV-18 account for 70% of them)
    • HPV-6 and HPV-11 cause condyloma acuminatum, and oral and laryngeal papillomas
    • Risk factors for infection and cancer progression: promiscuity, smoking, family history of cervical cancer, and immunosuppression

    Clinical Syndromes

    • Common warts: benign-self-limited skin proliferation
    • Head and neck tumors: single oral papillomas, most common benign tumors of oral cavity
    • Clinical characteristics: pedunculated, rough surface, papillary appearance, solitary, and recurrence is rare after surgical treatment

    Diagnosis and Treatment

    • Diagnosis: DNA molecular probe, PCR, Real-time PCR analysis (no culture)
    • Treatment: removal (if painful or for cosmetic reasons), medical treatment: stimulators of inflammation and innate immunity (imiquimod, interferon), antivirals (cidofovir)
    • Prevention: avoid contact with infected tissue, condom use may prevent transmission, immunization (tetravalent, nine-valent, and divalent vaccines)

    Adenoviruses

    • Genome: double-stranded DNA
    • Structure: non-enveloped, capsid with 240 capsomeres
    • Replication: 32-36 hours, around 10,000 virions
    • Initiation of infection: attachment of viral fiber proteins to a glycoprotein belonging to the Ig superfamily of proteins

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    Description

    This quiz covers the diagnosis and treatment of papillomaviruses, including the characteristics of warts, detection methods such as PAP smears and molecular probes, and treatment options. It also touches on the spontaneous regression of warts.

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