Abstract
The main goal of this study was to investigate, through a biomolecular study, the correlation between papillomatosis of the vulvar vestibule and human papillomavirus (HPV) infection, as well as to establish the necessity of treatment. A total of 44 female adolescents between 12 and 18 years of age were selected through a prospective study with a confirmed diagnosis of papillomatosis of the vulvar vestibule. Vulvar biopsies were obtained for the histological and biomolecular detection of HPV DNA through polymerase chain reaction (PCR). Twenty (45%) adolescents were virgins (group A), the other 24 (55%) were sexually active. The virgin adolescents (group A) and 12 sexually active adolescents (group B) did not show cytological and/or colposcopic alteration, suggesting infection by HPV either on the cervix or vagina. These were compared with 12 other sexually active adolescents who showed cervicovaginal infection caused by HPV (group C). Fisher exact test was applied for statistical analysis of the results, considering alpha equal or less than 0.05. There was no statistically significant difference in relation to HPV DNA through PCR among virgin and sexually active adolescents in group B, however, both differed from those in group C (A + B × C: p = 0.048*). The histological study did not reveal evident signs of infection caused by HPV on vestibular papillae, besides perinuclear halos. HPV DNA was detected on vestibular papillae in 27%. Our results confirmed a scarce correlation between vestibular papillae and HPV. Thus, we consider papillomatosis of the vulvar vestibule, in most cases, to be equivalent to physiological papillomatosis and, therefore, should not be treated.
Highlights
Genital human papillomavirus (HPV) infection is one of the most common sexually transmitted infections in sexually active adolescent and young adult women[1]
The 44 (100%) biopsy samples of papillomatosis of the vulvar vestibule were histologically characterized as papillas formed by the conjunctive-central vascular axis and coated with squamous epithelium
By means of the molecular biology technique, 4 (20%) of the 20 samples of vestibular papillae analyzed in group A tested positive for HPV by polymerase chain reaction (PCR)
Summary
Genital human papillomavirus (HPV) infection is one of the most common sexually transmitted infections in sexually active adolescent and young adult women[1]. HPV 6 and 11 are largely responsible for benign warts, while types 16 and 18 are primarily associated with intraepithelial neoplasias and invasive. The acuminate warts are recognized with their numerous superficial filiform projections that coalesce in a common base, densely veined and sessile, forming extensive and voluminous vegetations, which assume the appearance of cauliflower. The diagnosis of the vulvar subclinical forms is more complex due to greater number of physiological and pathological conditions that may appear similar[3]. In 1987, Campion[4] described three types of subclinical vulvar lesions, one of which was the vestibular papillae, and their relationship to the HPV infection. Papillomatosis is a relatively common clinical finding, its origin is yet uncertain
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