背景:尖锐湿疣是由人乳头瘤病毒(HPV)引起的,通常表现为异常,有花梗,乳头状瘤性病变,可能是苍白的颜色。在极少数情况下,我们观察到色素性生殖器病变与脂溢性角化病相似,但有尖锐湿疣的组织学发现和HPV基因分型阳性。我们称之为“脂溢性角化病样”型尖锐湿疣。
方法:这是一项观察性回顾性研究。收集以下临床数据:年龄,性别,进化的时间,location,孤立或多发性病变,单形或多形性/混合性病变。所有病例均进行HPV基因分型,切除8例进行组织学研究。
结果:共有31例患者被诊断为这种类型的色素性尖锐湿疣。其中,16个有孤立的病变(少于5个病变),15个有多个病变。67%的病变表现出缓慢的生长,演化期大于1年。最常见的位置是阴茎和耻骨的底部。在所有病例中,病变的HPV基因分型均为阳性,以HPV-6基因型为主(28例,90.3%)。病变表现出与其他色素性病变和归因于HPV感染的组织学发现的皮肤镜下差异(假性角化病,koilocytosis,等)和其他类似于在脂溢性角化病中观察到的那些。
结论:共有31例患者被诊断为色素性疣状病变,excresents,孤立的或多个,在生殖器区域。这些病变表现出与脂溢性角化病相似的临床特征,HPV基因分型阳性。在大多数情况下,基因型为HPV-6.这些病变被命名为“色素性尖锐湿疣脂溢性角化病样”。文献中仅描述了10例这些病变。
BACKGROUND: Condyloma acuminatum is caused by human papillomavirus (HPV), which typically presents as excrescent, pedunculated, papillomatous lesions which may be of a pale colour. On rare occasions, we have observed pigmented genital lesions that are similar to seborrhoeic keratoses, but with histological findings of condyloma acuminatum and positive genotyping for HPV. We have termed these \'seborrhoeic keratosis-like\' type condylomas.
METHODS: This is an observational retrospective study. The following clinical data were collected: age, sex, time of evolution, location, isolated or multiple lesions, monomorphous or polymorphous/mixed lesions. HPV genotyping was performed in all cases, and excision for histological study in eight cases.
RESULTS: A total of 31 patients were diagnosed with this type of pigmented condylomata acuminata. Of these, 16 had isolated lesions (less than five lesions) and 15 had multiple lesions. 67% of the lesions exhibited slow growth, with an evolution period of greater than 1 year. The most frequent location was the base of the penis and pubis. HPV genotyping of the lesions was positive in all cases, with the HPV-6 genotype predominating (28 cases, 90.3%). The lesions exhibited dermoscopic differences from other pigmented lesions and histological findings attributable to HPV infection (pseudoparakeratosis, koilocytosis, etc) and others similar to those observed in seborrhoeic keratoses.
CONCLUSIONS: A total of 31 patients were diagnosed with pigmented verrucous lesions, excrescents, isolated or multiple, in the genital region. These lesions exhibited clinical characteristics similar to seborrhoeic keratoses, with positive genotyping for HPV. In the majority of cases, the genotype was HPV-6. These lesions have been named \'pigmented condylomata acuminata seborrhoeic keratosis-like\'. Only 10 cases of these lesions have been described in the literature.