Домой Бородавки Бородавки на руках, ногах, лице

Бородавки на руках, ногах, лице

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Бородавки на руках, ногах, лице. Их разновидности. Папилломавирус.

Что такое бородавки?

Бородавки — это разрастания на коже в виде бляшек с сосочковой или плоской поверхностью, с наростами роговых масс или без них. В России в медицинской среде бородавками принято называть обычные бородавки на пальцах рук и ног, либо подошвенные. Все остальное называют папилломами. Бородавки на коже в паховой области называют остроконечными кондиломами. Разница между ними не принципиальна. Причина у всех этих бородавок одна и та же — папилломавирус. Лечение не сильно отличается. Что касается обычных людей, для них бородавкой может быть все, что угодно.

Откуда появляются бородавки?

Папилломавирус может обитать на коже, не вызывая проявлений. Но, когда папилломавирус проникает в кожу при повреждениях, он может заражать клетки в глубоких слоях эпидермиса кожи, вызывая рост бородавки.
У человека может появиться бородавка, если кожа была повреждена из-за царапины, пореза, заусенца, из-за того, что грызете ногти. Подошвенные бородавки часто встречаются у пловцов, чьи ноги не только постоянно размокшие и размягченные, но также поцарапаны и травмированы грубыми поверхностями в бассейне. Бородавки часто наблюдаются среди тех, кто разделывает и обрабатывает мясо, курицу, и рыбу.
Специфические гены, входящие состав ДНК папилломавируса, запускают производство белков, ответственных за неконтролируемый рост клеток в верхних слоях кожи или слизистых а заодно, и производство новых вирусов. Бородавки легко распространяются от зараженного человека за счет папилломавируса. На руках при прикосновении к бородавке пальцами скапливается большое количество папилломавирусов, которые можно затем перенести на другие области кожи, или другим людям.
Различные типы этого вируса хорошо сохраняются во влажных теплых средах: банях, духах, раздевалках, бассейнах.
Чтобы человек стал заразным иногда даже наличие бородавок необязательно, достаточно бессимптомное носительство. Однако общие предметы обихода значительно облегчают распространение. После попадания папилломавируса может пройти несколько месяцев, прежде чем сформируются бородавки. Значительное количество бородавок может уйти со временем самостоятельно в течение месяцев или лет. Не обязательно, что при контакте с папилломавирусом появятся новые бородавки. Некоторые люди гораздо больше других восприимчивы к этим опухолям.

Бородавки, кто в группе риска.

  • Нарушения в работе иммунитета;
  • Возраст: дети и подростки. По мере взросления можно обнаружить, как бородавки становятся меньше, или исчезают полностью;
  • Ходьба босиком по влажной поверхности в общественных душевых, раздевалках, вокруг плавательного бассейна;
  • Наличие общих полотенец, бритвы и другие личных вещей с человеком, который имеет бородавки;
  • Люди, грызущие ногти или кутикулы;
  • Ношение закрытой или тесной обуви, которая вызывает потливость ног.

Разновидности бородавок.

Существует несколько разновидностей бородавок, имеющих различный внешний вид, различные излюбленные места на теле, и вызываемые различными типами папилломавируса.

  • Обычные бородавки (verruca vulgaris), появляются чаще всего на руках, но они могут появиться на любом участке тела. Выглядят, как грубые, серо-коричневые, куполообразные наросты с шероховатой поверхностью. Они часто имеют внешний вид цветной капусты.
  • Плоские бородавки (verruca plana), часто мелкие, гладкие. Они имеют плоские вершины и могут быть телесного цвета или розовыми, светло-коричневыми, светло-желтыми. Зачастую возникают в больших количествах, группами в одной области. Плоские бородавки часто распространяются бритьем. Наиболее распространены на лице, шее, руках, запястьях и коленях.
  • Нитевидные бородавки, имеют вид плоской бородавки телесного цвета с роговыми пальцеобразными отростками. Растут чаще всего на лице, особенно, вблизи век, вокруг рта, носа и в области подбородка.
  • Подошвенные бородавки чаще имеют вид мозолей- натоптышей, но расположены вне зон опоры и трения и имеют в центре уплотнение. Иногда под поверхностью бородавки видны темные пятнышки («корни»). Подошвенные бородавки могут развиваться на любой части стопы. Когда давление при стоянии и ходьбе передается подошвенной бородавке под поверхностью, слой толстой, жесткой кожи, похожий на мозоль, формируется над ней. По мере затвердения и роста ходьба может стать болезненной, подобно ходьбе с камушком в вашей обуви.
  • Околоногтевые бородавки находятся под и вокруг ногтей. Они проявляются как грубые, неправильные неровности. Часто нарушают рост ногтей.
  • Остроконечные кондиломы обычно рассматриваются отдельно из-за своей локализации в интимных областях, большей склонности к раку, более бережных подходов в лечении.

Проявления бородавок.

  • Бородавки разнятся по размерам и форме. Опухоли зачастую имеют форму шишек с шероховатой поверхностью, а могут быть ровными и гладкими.
  • К бородавкам даже подрастают собственные сосуды для того, чтобы питать их кровью. Эти сосуды хорошо заметны на обыкновенных и подошвенных бородавках, где они выглядят, как черные точки в центре бородавки.
  • Иногда растут несколько месяцев, прежде, чем станут видимыми.
  • Бородавки, в частности, более новые, легко распространяются на другие части тела или других людей.
  • Часто покрывают линии и складки на коже, это один из признаков, отличающих бородавку от других кожных заболеваний, таких как родинки.
  • Обычно, безболезненны. Но бородавка, которая растет в месте, которое испытывает давление, например, на пальце или на нижней части ноги, может быть болезненной.
  • Подошвенные бородавки постоянно испытывают давление и кожа над ними утолщается. В результате часто сама поверхность бородавки не видна. Виден слой гипертрофированного эпидермиса, который выглядит и болит, как мозоль.
  • Околоногтевые бородавки часто нарушают рост ногтей.
  • Может быть трудно избавиться от бородавок после того как они появились. Но они, могут и исчезать самостоятельно в течение нескольких месяцев или лет.
  • Перед тем, как бородавки исчезают сами по себе, они часто чернеют.
  • У пациентов с клеточных иммунодефицитом, в том числе после пересадки органов и больных СПИДом или раком крови, количество обычных бородавок и остроконечных кондилом увеличивается.

Связаны ли бородавки и рак?

Бородавки, за исключением остроконечных кондилом, вызываются типами папилломавируса низкого риска. Это означает, что вероятность появления рака от бородавки крайне низка. Если когда-то и разовьется рак от обычной или подошвенной бородавки, скорее всего, это будет плоскоклеточный рак кожи. Нитевидные бородавки с плотными отростками роговых масс более опасны в этом отношении, чем обычные, плоские или подошвенные. Что касается бородавок в интимных областях (остроконечных кондилом), то они вызываются очень многими типами папилломавируса, среди которых есть высокого риска, ведущие к раку многих органов.

Типы папилломавируса в зависимости от вида бородавок

Вид бородавки Типы папилломавируса (часто выявляемые) Обычные бородавки, нитевидные, околоногтевые на коже пальцев и в других местах 1, 2, 3, 4, 7, 26, 27, 29, 41, 57, 60, 63, 65, и другие. Самые распространенные 2 и 4 типы Подошвенные бородавки 1, 2, 3, 4, 10, 27, 28, 58, 63 Плоские бородавки 3, 10, 28, 29, 49 Плоскоклеточный рак кожи 5, 8,14, 17, 20, 47

Диагностика бородавок.

Диагностика бородавок обычно основывается только на их внешнем виде. В редких случаях проводится более подробное обследование. Если вид образования не является типичным и у Вас имеется повышенный риск заболевания раком кожи, ваш доктор может взять образец опухоли и отправить его на исследование под микроскопом (биопсия кожи). Биопсия, обычно, делается, если опухоль темнее, чем кожа вокруг него. Или края опухоли неровные, нечеткие, имеется кровоточивость. Если бородавка очень крупная и очень быстро растет.

Заболевания, похожие на бородавки.

Существует ряд заболеваний, похожих на бородавки: себорейный кератоз, актинический кератоз, кожный рог, кератоакантома, бородавчатый акрокератоз, ангиокератома, беспигментная меланома. И даже бородавчатый туберкулез кожи или псориаз иногда имеют сходный внешний вид. Сирингомы, эпидермальные и трихилеммальные кисты, акрохондрон и милиум, как правило, не очень похожи и не вызывают диагностических затруднений. Плоские, похожие на бородавку околоногтевые бляшки на пальцах могут иногда оказаться Болезнью Боуэна и несут в себе папилломавирус высокого риска 16 и 18 типов. Подобно этому, беспигментная меланома может напоминать околоногтевую бородавку, и должна быть заподозрена при появлении кровоточивости или пигментации.
Красный плоский лишай (в том числе бородавчатый типа) может быть похож на плоские бородавки, и подобно ему, высыпания часто располагаются в линейном порядке. Белые полоски в виде сетки на поверхности красного плоского лишая помогут различить эти два заболевания.
Подошвенные натоптыши (мозоли), часто неправильно принимают за бородавки. На поверхности бородавки обычно видны черные точки, представляющие собой мелкие сосуды, закупоренные тромбами (в народном представлении «корни»). Поэтому, удаление верхнего рогового слоя приводит к кровотечению из поверхностно расположенных кожных сосочков. Мелкоточечный порокератоз, порома, иногда похожи на подошвенные бородавки. Бородавки рук мясников и других связанных с обработкой мяса или рыбы людей часто крупные, напоминают цветную капусту, сосуществуют с обычными бородавками.
Бородавки, которые появляются на необычных местах (на лице и шее), нужно отличать от контагиозных моллюсков, которые имеют вид куполообразных блестящих папул с центральным втяжением.

Когда надо показать бородавки врачу? Осложнения.

  • Вы не уверены, что это действительно бородавка, а не что-то другое.
  • Если вы старше 60 лет и у Вас никогда раньше не было бородавок, обратитесь к дерматологу или онкологу для исключения рака.
  • Самолечение в течение двух или трех месяцев не увенчалось успехом.
  • Бородавки растут и распространяются стремительно, несмотря на лечение.
  • Появились признаки бактериального поражения, в том числе:
    1. Увеличение боль, отек, покраснение, чувствительность или жжение.
    2. Появились красные полосы, исходящие из бородавки.
    3. Появился гной.
    4. Появился жар или озноб.
  • Ходьба с подошвенными бородавками стала невыносимо болезненна.
  • У Вас имеется сахарный диабет или заболевания периферических артерий (атеросклероз, эндартериит), и появились бородавки на подошвах.
  • У Вас имеются бородавки в интимных областях или вокруг заднего прохода.

Надо ли лечить бородавки?

Не все бородавки нуждаются в лечении. Часто они исчезают сами в течение нескольких месяцев или лет. Так происходит в связи стем, что со временем, иммунная система человека учится сама уничтожать папилломавирус, который вызывает бородавки.

Вы можете решить лечить бородавки, если они:

  • Беспокоят Вас болью;
  • Смущают внешнем видом;
  • Легко воспаляются и раздражаются;
  • Растут или распространяется на другие части вашего тела;
  • Вы не хотите заражать других людей, живущих или общающихся с Вами.

При лечении бородавок стремятся к наименьшей вероятности образования рубца. Потому, что рубец может в дальнейшем вызывать больший дискомфорт, чем сама бородавка. Так же важно искоренить папилломавирус, чтобы он не остался в коже (на слизистых) и не вызвал рецидивов или новых бородавок в будущем. Способ лечения бородавки зависит от типа бородавки, ее местоположения, и ее проявлений. Большое значение имеет запас времени, терпения и финансовые возможности человека.
Лечение бородавок не всегда успешно. Даже после того как от бородавка полностью отвалилась и от нее не осталось и следа, она может вернуться или распространиться на другие части тела. Это потому, что большинство методов лечения только разрушают саму бородавку а не уничтожают папилломавирус, который ее вызвал.
При лечении в клинике самое главное — уверенность в диагнозе. В случае подозрения на что-то нехорошее — возможна биопсия. По просьбе пациента процедуры проводят при местном обезболивании. Доктор может заметить бородавки в труднодоступных местах, кроме того, указать на те образования, которые Вы сами бородавками не считали. Важна так же быстрота, с которой проводится удаление. Из современных методов удаления наибольшее предпочтение следует отдать криодеструкции, она вызывает менее заметные рубцы. Удаление лазером или электрокоагуляцию, радиохирургический метод использовать в случае неэффективности криодеструкции.
При лечении бородавки в домашних условиях страшно перепутать диагноз и начать удалять кератоакантому, кожный рог, плоскоклеточный рак кожи, беспигментную меланому. Все эти заболевания, когда они небольших размеров — достаточно похожи. Но от самолечения только вырастут. В случае меланомы, лечение в домашних условиях, и вовсе, опасно смертельным исходом от метастазов в течение ближайших лет.
Из лечения в домашних условиях наиболее популярна криодеструкция диметиловым эфиром (вартнер крио, криофарма). Такая криодеструкция менее эффективна, чем заморозка жидким азотом. Для подошвенных или крупных обычных бородавок может не подойти. Средства на основе салициловой кислоты (салипод и другие) и трихлоруксусной кислоты (вартнер) достаточно дешевы. В то же время, рубцы от них небольшие. Веррукацид и кондилин так же эффективны. Для лечения бородавок в интимных областях лучше подойдет имихимод. Для лечения плоских мелких бородавок на лице — так же лучше использовать ретиноевую мазь или имихимод. В случае больших бородавок можно использовать 5-фторурацил крем.
Существующие основные методы лечения бородавок после успешного завершения лучше всего дополнять различными мазями, таблетками, стимулирующими иммунитет. Такими как панавир, циклоферон, полиоксидоний.
Современные прививки от папилломавируса Гардасил или Церварикс предотвращают появление части бородавок, в основном, в интимных областях. В этом отношении более полезен Гардасил из-за своего состава.

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