目的研究临床酷似假性湿疣的尖锐湿疣的病原学。方法回顾性分析温州医科大学附属第一医院2013年1月—2015年12月收治的典型尖锐湿疣(15例)、假性湿疣(15例)、假性湿疣样尖锐湿疣(25例)患者的临床资料。对比分析3组患者的临床表现、病理学表现及HPV分型,以探讨临床酷似假性湿疣的尖锐湿疣的病原学特征。结果典型湿疣皮损表现为疣状粗糙、易破溃的淡红色小丘疹;假性湿疣皮损多为发于两侧小阴唇内侧的1~2 mm大小群集丘疹;假性湿疣样尖锐湿疣临床表现酷似假性湿疣。典型尖锐湿疣醋酸白实验阳性,假性湿疣阴性,假性湿疣样尖锐湿疣弱阳性。尖锐湿疣HPV全部阳性[4种低危HPV(6、11、43、55)、10种高危HPV(16、18、33、39、51、52、53、58、59、66)],1种HPV亚型4例,2种HPV亚型6例,3种HPV亚型3例,4种HPV亚型2例;假性湿疣HPV检测全部阴性;假性湿疣样尖锐湿疣HPV全部阳性[3种低危HPV(6、11、81)、7种高危型HPV(16、18、33、35、51、53、58)],1种HPV亚型8例,2种HPV亚型12例,3种HPV亚型3例,4种HPV亚型2例。结论临床表现为假性湿疣的患者中可能包含高危HPV感染的尖锐湿疣。
Objective To study the clinical etiology of pointed condyloma with pseudocondyloma features. Methods Patients with pointed condyloma( 15 cases),pseudocondyloma( 15 cases),and pointed condyloma with pseudocondyloma features( 25 cases) in our hospital from January,2013 to December,2015 were retrospectively analyzed. The clinical features,pathology,and HPV type of 3 groups were compared and analyzed,to study the clinical etiology of pointed condyloma with pseudocondyloma features. Results Warty lesions of typical pointed condyloma showed rough,easily rupture small reddish pimples; Warty lesions of pseudocondyloma lesions mostly showed 1- 2 mm cluster size pimples on inside of the labia minora at both sides; Warty lesions of pointed condyloma with pseudocondyloma features was the same with pseudocondyloma lesions. Acetic acid white experiment of pointed condyloma showed positive,acetic acid white experiment of pseudocondyloma showed negative,and acetic acid white experiment of pointed condyloma with pseudocondyloma features showed weakly positive. All pointed condyloma showed HPV-positive[4 kinds low-risk HPV( 6,11,43,55),10 kinds high-risk HPV( 16,18,33,39,51,52,53,58,59,66) ],one HPV subtypes 4 cases,two HPV subtypes 6 cases,three HPV subtypes 3 cases,four HPV subtypes 2 cases; pseudocondyloma HPV tests were all negative; pointed condyloma with pseudocondyloma features showed HPV-positive[3 kinds low-risk HPV( 6,11,81),7 kinds high-risk type HPV( 16,18,33,35,51,53,58) ],one HPV subtypes 8 cases,two HPV subtypes 12 cases,3 HPV subtypes 3 cases,four HPV subtypes2 cases. Conclusion Patients with pseudocondyloma features might contain high-risk HPV infection of the genital warts.