The human papilloma virus is a virus that belongs to small family Papoviridae. They are viruses with appetite for epithelia and more than 100 different. There are types that affect the skin or mucous. The mucosal types are those that affect genital tract. Between these, solo 15-20 They can cause malignant or premalignant genital.

The genital infection papillomavirus is very common, both women and men. Generally, infection with the human papilloma virus in women is seen in about 10% of the cases.

The infection is especially common in young women , and age, a progressive decrease is observed. Later, around 55 years there is a further increase in the number of cases.

Generally, infection by the human papilloma virus are resolved naturally without treatment. The first year will heal the 70% of the cases, and the 2 years, he 90% .

Infections with HPV that persist over time to be controlled, the risk of produce premalignant or malignant lesions of the lower genital tract.

In the cervical infection it occurs in a specific area of ​​nominated transformation zone, where the phenomenon occurs squamous metaplasia (re-epitelizacion, replacement with scar tissue instead of glandular tissue)
This phenomenon can be observed in other locations, as, for instance, the anal canal.

The human papillomavirus produces epithelial changes progressively develop and, over time, They can produce cervical cancer or other organs.

The progression of lesions ranging from low-grade intraepithelial lesions to bind grade intraepithelial lesions and carcinoma in generates,l low-grade lesions express a recent infection and usually disappear spontaneously over a period of time. On the contrary, high-grade lesions are more likely to progress and, so, increased risk of malignancy.

The persistence time is a risk factor of malignancy, and the type of virus. The type 16 It is the one with greater tumorigenicity, Y, also, It is also the lingering longer.


Premalignant cervical lesions are usually asymptomatic. Malignant can cause bleeding and smelly flow, and bleeding with intercourse and pain..

The HPV can affect the cervix, can produce premalignant and malignant lesions, (cervical cancer) It is produced by the neoplasm more frequent among those produced by the human papillomavirus. However, it can also produce premalignant and malignant lesions in other locations. In the lower genital tract may affect vaginal (VAIN) and vulva (WINE). It can cause lesions of the anus(AIN). These lesions comprise the so-called "syndrome genital tract neoplastic human papillomavirus inmferior.por.

Premalignant cervical lesions


Premalignant cervical lesions are usually asymptomatic. Malignant can cause bleeding and smelly flow, and bleeding with intercourse and pain

He diagnostico It is performed by

  • Cytology, the cytological lesions were classified according to the Bethesda classification.
  • Colposcopy Colposcopy is the visualization of the cervix with an instrument with a magnifying glass to visualize the cervix and injuries detectoar
  • Dirigida biopsy by colposcopy. It allows the diagnosis of security.
  • Derterminacion of human papillomavirus. Sometimes specific.


The treatment consists of cervical conization .The most widespread technique is the diathermic loop., although there are others available as laser or scalpel is generally performed in high injury grado.Es important to monitor patients, as recurrence after conization may appear until many years.

The low-grade lesions can be followed on an outpatient basis and regularly

Premalignant lesions of the vulva (WINE)

Premalignant lesions of the vulva (WINE), They have a differential characteristic: It can be divided into two completely different groups ( different ages, patient types and clinical behavior) different:

  • The common VIN, that relates to the papillomavirus infection
  • Differentiated VIN, that is not associated with this infection. In the vast majority of cases this type which is associated with carcinoma of vulva.


Vulvar lesions (WINE) They may be asymptomatic, or cause some discomfort such as itching or itching. Sometimes you can be in the form of ulcer. In these cases it is important to rule out the case of a carcinoma of the vulva.

In vulvar cancer and precancerous lesions screening is not recommended, so it is important to make a careful examination of the vulva in preventive visit.

Injuries can have a varied appearance, and only by aspectoes very difficult to diagnose. you can see large raised, differently colored, reddish, brown, single or multiple. ulceradas.. VIN can be associated with other malignancies, especially in young women and human papilloma virus infection.


History and thorough and systematic exploration- The examination should include the entire tract genita (perianal area, perineal, parauretral, anal, cervix
Vulvoscopia and directed biopsy-


It depends on several variables such as age, immunosuppression, pregnancy, characteristics of injuries, (ulceration) number, location and extent of injuries.

Possible treatments are: Local surgical excision, Co2 laser vaporization, medical treatment (con imiquimod, although other treatments), vulvectomy skin.- Partially or completely, in very large cases. Observation without treatment can be performed in selected cases of young women, conducting strict control.

It is very important to properly track of patients once treated, especially if the excised lesion margins have not been cleared, because it is frequent relapses.

Vaginal precancerous lesions, (VAIN)

Vaginal intraepithelial lesions are rarer, as well as vaginal cancer.. Sometimes they associated with prior hysterectomy for cervical intraepithelial lesions..


Usually asymptomatic.

The diagnosis is made by colposcopy and directed biopsy.
Determination of human papillomavirus

He treatment can be:

  • Exeresis quirurgica, In cases with a history of hysterectomy vaginal vault located in
  • Co2 laser vaporization: chaos of high-grade CIN lesions uterus intact
  • Other treatments
  • Observation, if low-grade lesions

Neoplasia Anal.……


The genital warts or genital warts are benign lesions caused by papillomavirus. They are one of the sexually transmitted diseases more frequent. They are caused by the human papillomavirus, especially types 6 Y 11.

They are fleshy growths that appear on the skin and mucosal areas of the external genitalia. They can be small and limited number or be multiple and large. They are pink or gray. A presentation is condyloma acuminata

The most common location is in the vulva, but they may also appear in the perineal and perianal region. Anal., vagina, cervix. They can also appear in other locations such as the mouth, language or urethra.


They can be asymptomatic, although their presence often leads to discomfort or anxiety in patients.
According raramenente locations can cause anal bleeding, difficulty in urination


It is made by clinical examination, You can perform application of acetic acid to place more emphasis on injury.

If in doubt diagnosed, lack of response to treatment or suspected malignancy biopsy can be performed


There are several medical and surgical treatments. Medical treatments can be applied by a physician or applied by the patient.

Genital warts treatments are based on:

  • Physico-chemical destruction: Cryotherapy, laser vaporization. TCA BCA, podofilotoxina
  • Immunotherapy: imiquimod, sinecatequinas del te verde
  • Excision quirurgica. Cold scalpel, electric, laser vaporization

No treatment has been shown to be superior to another, In addition, are frequent recurrences. The treatment does not prevent subsequent infection or infectivity.

Screening for other sexually transmitted diseases is recommended, Condom use, reduce / eliminate snuff. Vaccination against human papilloma virus can significantly reduce the recurrence of genital warts, appearing in 30-40% of the cases.