Characteristics of clinical manifestation of pointed condylomas in men practicing sex with men

Abstract

The study objective is to investigate the characteristics of clinical manifestation of pointed condylomas (PCs) in men practicing sex with men (MSM).Materials and methods. Eight MSM were under observation: 2 stable pairs and 4 unrelated homosexuals. Among them, 5 were between the ages of 18 and 26, 3 – between 40 and 51. In every case, men complained of nodular rash in the area of external genitals or anus. A test was performed to determine the presence of human papilloma virus (HPV) of high (16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 71, 82) and low (6, 11, 44) cancerogenic risk.Results. In 4 patients, PCs were previously removed by destructive therapy multiple times. Remission lasted from 1 to 9 months. At the first examination, PCs on the penis were observed in all 8 patients, and in 3 PCs were also observed in the perineal area; 3 patients had PCs on the oral mucosa along with anogenital PCs. PCs appeared in the period between 3 weeks and 1.5 months prior to doctor visit. A trend towards rapid dispersion and expansion and fusion of PCs was noted by all patients. Associations of 2 HPV types were observed in 2 patients, of 3 types – in 3 patients, of 4 types – in 2 patients. HPV types of both high and low oncogenic risk were detected, but urethra, mouth and anus materials always contained DNA markers for type 6 and 11 HPV.Conclusion. MSM have the highest risk of HPV infection. All forms of homosexual sex are risk factors for HPV infection. Multicentricity and variety of proliferative skin and mucosal lesions are characteristic of the infection caused by HPV in MSM. Even in the absence of complaints, it is necessary to examine oral mucosa, tonsils and throat to rule out possible infection (including asymptomatic forms of HPV). PCs in MSM have a tendency towards rapid dissemination and growth. Type 6 and 11 HPV absolutely dominate in PCs. Meanwhile, different types of HPV in urethral, oral and anal materials can be explained both by contamination and uneven affinity of different HPV types towards epithelial cells of derma and mucosa.