HUMAN PAPILLOMAVIRUS, CLINICAL, DERMATOLOGICAL AND GYNECOLOGICAL APPROACH

Abstract

Introduction: Human papillomavirus (HPV) infection is associated with a wide range of cutaneous and mucosal manifestations. The spectrum of HPV ranges from inapparent infections, through multiple benign clinical presentations, including cutaneous and mucosal disease, to malignant and premalignant conditions. Cervical cancer is the fourth cancer with the highest incidence in women in the world, being the second cause of cancer death in women between 15 and 44 years of age, one of the risk factors for this cancer is the human papillomavirus. Objective: to detail the current information related to human papillomavirus, description, etiology, epidemiology, pathophysiology, anamnesis, physical examination, evaluation, treatment, differential diagnosis, prognosis, prevention and complications taking into account a clinical, dermatological and gynecological approach. Methodology: a total of 27 articles were analyzed in this review, including review and original articles, as well as clinical cases, of which 18 bibliographies were used because the other articles were not relevant for this study. The sources of information were PubMed, Google Scholar and Cochrane; the terms used to search for information in Spanish, Portuguese and English were: human papillomavirus, HPV, dermatosis, warts, infection, papanicolau, tumor virus infections. Results: HPV has been associated with the development of laryngeal, mouth, lung and anogenital cancers. Subtypes 6 and 11 are low risk and are usually associated with the formation of condylomas and low-grade precancerous lesions. Subtypes 16 and 18 are high-risk and are responsible for high-grade intraepithelial lesions that progress to malignant neoplasia. There are more than 180 HPV subtypes.The prevalence of genital HPV in adults aged 18-59 years is about 45.2% in males and 39.9% in females. The prevalence of high oncogenic risk HPV genotypes is 2.26%; (95%CI: 1.75-2.78), with the most common genotype being 16 (28.89%). Cervical cancer screening with cytology has significantly reduced the incidence and mortality of this type of cancer in developed countries, despite the fact that its sensitivity for detecting CIN2+ is around 66%. Conclusions: it is of remarkable importance to know the human papillomavirus outlook, especially because it is linked to a number of underlying clinical manifestations both benign, premalignant and malignant conditions. The authors recommend prevention, especially suggesting that boys and girls be vaccinated against HPV starting at 11 to 12 years of age, in addition to the other measures outlined in the article. It is important to understand that HPV alone does not cause cancer, but requires triggering factors such as smoking, folate deficiency, exposure to ultraviolet light, immunosuppression and pregnancy. Individuals with cutaneous warts have numerous treatment alternatives available, including surgical removal, cryotherapy, irritant or immunomodulatory drugs, and laser removal. KEY WORDS: HPV, infection, pap smear, warts.