Домой Бородавки Виды бородавок и кондилом на руках, лице и теле

Виды бородавок и кондилом на руках, лице и теле

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Виды бородавок

Даже на самой ухоженной и здоровой коже могут появиться бородавки – небольшие округлые узелки, которые относятся к доброкачественным новообразованиям. В большинстве случаев за их появление «отвечает» вирус папилломы человека (ВПЧ), носителем которого является практически каждый взрослый человек, порой даже не догадываясь о его наличии.

Виды бородавок различаются по размерам, месту и причинам их появления. Как и в случае с родинками, строгого формуляра нет – например, в актуальной версии Международной классификации болезней их можно найти сразу в четырех разделах: «вирусные бородавки», «болезни, передающиеся половым путем», «болезни кожи» и «доброкачественные образования».

Основные причины появления этих новообразований – разнообразные микротравмы кожного покрова, угнетение иммунной системы. В результате происходит активизация уже имеющегося в крови ВПЧ или инфицирование чужим вирусом. Заражение может произойти различными способами, в основном при непосредственном контакте с кожей, слизистыми носителя (в т.ч. половым путем), а также в различных бытовых ситуациях: пользование чужими полотенцами, нестерилизованными маникюрными инструментами, при посещении общественных бассейнов, саун и т.д.

↑ Вирусные бородавки

Выделяют 5 основных видов бородавок вирусного происхождения – простые, плоские, подошвенные, нитевидные и остроконечные, – которые различаются формой, размерами, локализацией и другими характеристиками. Рисков злокачественного перерождения они, как правило, не несут, и могут удаляться врачом-косметологом без дополнительного гистологического исследования.

  • Простые (обыкновенные, вульгарные) бородавки

Чаще всего образуются на тыльной поверхности кистей рук, на пальцах рук и ног. На вид представляют собой ороговевшие плотные папулы размером от 1 до 10 мм в диаметре, как одиночные, так и множественные. Во многих случаях проходят без лечения, самостоятельно (иногда очень слабо реагируют на терапию, а затем – через несколько месяцев или даже лет – самопроизвольно «рассасываются»). Подошвенные образования могут причинять дискомфорт при ходьбе.

Некоторые виды бородавок. Фото 1 – простые:
Фото 2 – бородавки на руках:
Фото 3 – плоские бородавки:
  • Плоские бородавки

Возникают у детей и подростков, поэтому носят также название юношеских. Представляют собой папулы диаметром от 1 до 5 мм, которые возвышаются над поверхностью кожи на 1-2 мм. Имеют гладкую поверхность с четко ограниченными контурами неправильной формы. Локализуются в основном на лице, шейной области, тыльной стороне кистей, голенях после различных царапин, ссадин и других раздражений кожи. Цвет розовый, телесный или светло-коричневый.

  • Подошвенные и ладонные бородавки

Эти образования появляются на подошвах ног (как правило в местах постоянного давления обуви), реже – на ладонях. Могут быть как почти плоскими, так и сильно выступающими над поверхностью кожи. Внешне очень напоминают мозоли, что зачастую затрудняет своевременную диагностику. Считаются наиболее болезненным видом бородавок и наиболее трудно поддающимся лечению.

Некоторые виды бородавок. Фото 4 – на ногах:
Фото 5,6 – подошвенные:
Фото 7,8 – нитевидные бородавки на веках и на губах:
  • Нитевидные бородавки (акрохорды)

Представляют собой довольно крупные – иногда более 1 см – наросты вытянутой формы, телесного цвета. Основная «среда обитания» – кожа лица и шеи, в частности веки, губы, нос и подбородок, а также подмышки и субмаммарные складки. Акрохорды могут довольно активно распространяться по соседним с пораженными участкам тела и сливаться между собой. Практически никогда не пропадают сами по себе, а в случае удаления показывают высокий процент рецидивов.

  • Остроконечные бородавки или кондиломы

Маленькие кожные наросты, обычно – розового цвета, которые часто сливаются в сосочкообразные разрастания. Образуются такие папулы на половых органах (крайняя плоть и головка полового члена, уретра, большие и малые половые губы, преддверие влагалища и др.), а также в области заднего прохода и в полости рта.

Остроконечные папилломы, они же аногенитальные (венерические) бородавки.
Фото 9 – в области заднего прохода:
Фото 10,11 – в преддверии влагалища и на половых губах:
Фото 12 – бородавки на половом члене:

Инфицирование происходит при половых контактах с носителем, особенно возрастает риск заразиться через микротравмы в паховой области. При отсутствии лечения кондиломы разрастаются до больших размеров и могут нанести здоровью существенный вред: стать причиной других инфекционных заболеваний половых органов, причинять неудобства и боль во время полового акта или дефекации.

↑ Старческие бородавки или себорейные кератомы

Эти образования возникают в пожилом возрасте, реже – в среднем. Причиной их появления являются возрастные изменения кожи, не связанные с ВПЧ. Кератомы представляют собой плоские мелкие папулы с четкими границами, желтого или розового цвета толщиной до 1-2 см. Они как бы прилеплены к коже и покрываются жирными корками, которые легко снимаются. Со временем становятся плотными, с мелкимитрещинками и приобретают грибовидную форму черного или темно-коричневого цвета.

Фото 13 – себорейная кератома:

Иногда новообразование имеет куполообразную форму с гладкой поверхностью и вкраплениями черных или белых «жемчужин» диаметром до 1 мм. Старческие образования чаще всего располагаются на груди, лице, шее руках, кроме ладоней и подошв. Размер составляет от 2 мм до 3 см, реже – 4-6 см. Иногда количество очагов может достигать нескольких десятков.

Фото 14 – множественные кератомы (себорейный кератоз):

В некоторых случаях происходит задержка роговых масс в эпителии, в результате чего такие бородавки становится похожи на меланому: границы опухоли нечеткие, а консистенция мягкая. Себорейные кератомы не обладают злокачественным потенциалом, но требуют внимательной диагностики, поскольку именно под них нередко «маскируется» рак.

↑ Другие виды бородавок

Существует еще несколько новообразований, которые имеют все признаки бородавок и ранее относились к той же группе, что и вышеописанные вирусные, однако, в настоящее время рассматриваются отдельно. Все они имеют ненулевую вероятность злокачественного перерождения и поэтому их лечение требует обязательного участия онколога:

Примерно так при большом увеличении выглядит вирус папилломы человека:
  • Папиллома мочевого пузыря

Доброкачественное образование, как правило единичное. Представляет собой мягкий светло-розовый нарост с неоднородной поверхностью, состоящей из многочисленных ворсин. Может иметь как явную клиническую картину, схожую с онкологической (кровотечения, боли, расстройство мочеиспускания), так и не проявляться вовсе. Папиллома мочевого пузыря имеет очень высокие шансы злокачественного перерождения, поэтому в большинстве случаев показано ее оперативное удаление.

  • Папиллома шейки матки

Прямое следствие ВПЧ, образующееся на фоне сниженного иммунитета – в т.ч. нередко появляется в ходе беременности. Как правило, протекает бессимптомно и зачастую проходит самостоятельно. Однако, с небольшой вероятностью может привести к раку шейки матки, поэтому при обнаружении такой папилломы обязательно проводится противовирусное лечение либо ее удаление.

  • Папиллома гортани (голосовых связок)

Один или несколько круглых наростов с ребристой поверхностью, которые в большинстве случаев появляются в детском возрасте и, как правило, у лиц мужского пола. Причиной считается все тот же ВПЧ, а основной симптом – прогрессирующая охриплость голоса. Папиллома гортани имеет относительно высокие шансы злокачественного перерождения, кроме того, существуют и другие серьезные риски для жизни: во-первых, нарост в буквальном смысле перекрывает воздух, затрудняя дыхание вплоть до гипоксии, во-вторых – бородавки могут распространиться в трахеи, легкие и бронхи, что приводит к легочной недостаточности. Поэтому при обнаружении проблемы в большинстве случаев показано хирургическое удаление.

  • Аногенитальные (венерические) бородавки

Это новое «официальное» название для вышеописанной остроконечной кондилломы, которая в 10-й версии Международной классификации болезней отнесена к разделу «болезни, передающиеся половым путем».

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