Comprehensive Analysis of Recurrence Factors of Complications of Genital Warts

nbsp; nbsp; A large number of studies have shown that there are fewer reasons for the recurrence of single sharp warts, including some factors such as HPV reinfection. 1. The damage of sharp warts and/or HPV has been completely removed. nbsp; nbsp; nbsp; The incomplete removal of sharp warts damage and/or HPV is one of the main factors causing the recurrence of sharp warts. Some scholars found that after the treatment of sharp warts to remove the wart body, 45% of patients still had HPV latent infection, among which 67% of patients showed recurrence. This indicates that HPV has not been thoroughly cleared by the body, and the residual sharp wart lesions or latent HPV infection is an important reason for the recurrence of sharp warts. The author believes that in the process of treating sharp warts, each type of topical therapy will greatly extend the recurrence of sharp warts if carefully operated, especially when controlling the scope and depth of tissue reaching complete removal of HPV infection. However, it is not always possible to achieve this during clinical treatment, which is closely related to the technical level of the operator. nbsp; nbsp; nbsp; It was mentioned earlier that the HPV infection site is mainly in the epidermis, and the sharp warts grow outward from the epidermis. Whether using topical drugs or laser therapy, the treatment depth must reach below the basal layer of the epidermis, and the treatment range must exceed the edge of the sharp wart lesion by 1-2 mm to clear the sharp wart lesion tissue. Male patients with sharp warts commonly experience psychological barriers associated with sexually transmitted diseases. However, even in clinical treatment processes where this is achieved, many patients with sharp warts still recur after treatment. Bai Wen yuan et al. studied and found that HPV DNA could be detected in the dermis of many patients with sharp warts. This result indicates that in cases of sharp wart recurrence, besides the presence of HPV within the skin epidermis, the existence of HPV within the dermis is another important cause of sharp wart recurrence. The question is, since HPV is a virus that prefers the epidermis, why does HPV exist in the dermis? There are several possible explanations: ① Due to the inflammatory response of the skin to HPV infection, leading to the release of HPV DNA, such as inflammation causing liquefaction degeneration of basal cells, which can lead to the release of HPV particles into the dermal papillae; ② In unknown AIDS patients, HPV may be contained within Langerhans cells, lymphocytes, and binucleated cells in the epidermis. These cells may phagocytose HPV DNA in the epidermis of sharp warts, allowing them to migrate from the epidermis to the dermis; ③ HPV viremia leads to the presence of HPV in the dermis, but due to the inability to detect the virus in the blood serum using immunological methods, this possibility is significant. 2. Cross-infection of sharp warts nbsp; nbsp;, Sharp warts Comprehensive analysis of recurrence factors of sharp warts complications; nbsp; It was mentioned earlier that during the treatment process of laser therapy and surgical excision, HPV-infected lesion tissues may contaminate other areas, such as inoculation around and at a distance from the sharp wart lesions, resulting in sharp warts. 3. Items contaminated by HPV nbsp; nbsp; nbsp; In the transmission routes of sharp warts, direct infection routes have also been mentioned, which can also become one of the factors for the recurrence of sharp warts. For example, if towels contaminated by HPV used by patients have not been properly treated, further contact might cause the recurrence of sharp warts. Bergeron et al. observed that underwear contaminated by HPV could also be a reason for the recurrence of sharp warts. 4. HPV infection or possession of sharp warts by sexual partners nbsp; nbsp; nbsp; If the patient's sexual partner has HPV infection or sharp warts that have not been completely treated, the patient may experience a recurrence of sharp warts after resuming sexual contact. 5. Subclinical manifestations of sharp warts and latent HPV infections nbsp; nbsp; nbsp; Subclinical manifestations of sharp warts and latent HPV infections are the most important causes of sharp warts and their recurrence. Erpenbach et al. reported that subclinical manifestations of extensive mucosal sharp warts and latent HPV infections could cause the recurrence of 30%~70% of sharp warts cases, particularly in female patients with sharp warts. Zhou Hua et al. detected using PCR technology and found that among those who were HPV positive in the perianal area, 37.5% experienced recurrence. 6. Integrity of the immune system nbsp; nbsp; nbsp; As mentioned later, changes in the immune system of patients with sharp warts play an important role in the occurrence, development, and remission of sharp warts. Therefore, various internal and external factors that reduce immune function and disrupt the regulation of immune responses, ultimately leading to imbalance or defects in the cellular immune system, are very important factors in the vicious cycle of sharp warts recurrence. 7. Others nbsp; nbsp; nbsp; Other factors causing sharp warts recurrence include poor personal hygiene habits, long foreskin in females, various genital tract infections in children, and the increased secretion caused by these conditions, creating a moist local environment. nbsp;