Домой Бородавки Вирусная бородавка на пальце ноги, руки: диагностика, лечение у детей и взрослых

Вирусная бородавка на пальце ноги, руки: диагностика, лечение у детей и взрослых

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Причины, симптомы и лечение вирусных бородавок

Введение

Вирусная бородавка – это нарост на коже доброкачественного характера, который вызывается вирусом папилломы человека. Заболевание называется ПВЧ, или просто папилломавирусная инфекция.

Сегодня этот вирус самый распространенный, заражены им 90% населения Земли. Чаще встречается у женщин. Зарегистрировано 130 штаммов, 90 из них поражают кожу и слизистые. Полностью излечиться от ПВИ невозможно.

Какой вирус провоцирует возникновение наростов?

Вирус ВПЧ в отношении человека высокоспецифичен, он инфицирует и трансформирует базальные клетки эпителия (кератоциты). Наиболее часто причиной возникновения вирусных бородавок являются ВПЧ 1, 2, 4, 27 и 57. Реже выявляются ВПЧ 3, 7, 10 и 28, 41, 65, 88 и 95 типов.

  • 1, 2 и 4 тип выявляется при подошвенных бородавках;
  • 2, 4, 26, 27, 29, 57 — при вульгарных;
  • 3, 10, 28, 49 типов – при плоских.

В клетках базального слоя вирус может находиться очень долго в латентном состоянии. Процесс репликации ВПЧ начинается только при появлении благоприятных факторов.

Описание наростов, места локализации: руки, ноги, пальцы

Бородавка – самая частая форма проявления ВПЧ. Она представляет собой образование на коже в виде узелка, чаще телесного или светло-коричневого цвета, размером от 1 до 10 мм.

Нарост может быть одиночным или множественным. Его форма круглая, плотная и выпуклая, с четкими границами. Сначала появляется главная бородавка – материнская, а уже вокруг нее формируются дочерние.

Рост бородавок в большинстве случаев замедлен, они постепенно разрастаются и выступают на поверхность. Никаких симптомов вначале не вызывают, поэтому человеку часто кажется, что папиллома появляется внезапно. В зависимости от своей локализации бородавки впоследствии травмируются, болят и кровоточат.

В каком возрасте они могут проявиться?

Обычно бородавки появляются у молодых людей в возрасте от 18 до 30 лет, которые сексуально активны – если речь идет об аногенитальных бородавках. Последние годы число анальных папилломы выросло в связи с ростом интереса к анальному сексу.

Нередко они возникают после 40 – тогда говорят о возрастных бородавках. Дети очень часто имеют бородавки в силу вредных привычек (грызут ногти и сосут пальцы), очень активно познают мир и все тащат в рот.

Даже младенцы не застрахованы от ВПЧ, если у матери имеются генитальные наросты. Заражение происходит при родах. Это часто выражается в папилломатозе гортани, в результате которого может наступить обтурация.

У детей

Частота бородавок у детей связана с их высокой активностью – они очень подвижны, часто падают, играют и возятся в песочнице, ныряют в водоемы и пр. В этих условиях они часто находятся без обуви, а мелкие кожные повреждения – обычное дело.

Бородавки у детей развиваются своеобразно, это обусловлено тонким слоем эпидермиса и нежной детской кожей. Сначала на одном месте возникает целое скопление мелких уплощенных возвышений, телесного цвета. В центре находятся более крупные. Чаще начинаются с пальцев рук, а потом распространяются дальше.

У взрослых

У взрослых бородавки связаны часто с профессией — уборка помещений, сбор мусора, сельхоз работы и т. д. Эти люди чаще других подвергают свою кожу микротравмам, которые подчас остаются незамеченными. Для взрослых характерно одиночное расположение вирусных наростов.

Бородавки имеют сморщенную шероховатую поверхность. В своем развитии они проходят несколько стадий: скрытая, активная и старение.

На последнем этапе они преобразуются в плотные, ороговевшие узелки. В такой форме они могут и отпадать. 70% бородавок исчезают сами, через 2 года после своего появления, но с таким же успехом и возвращаются, уже на другие места.

Какими бывают и как выглядят?

Медики выделяют следующие виды:

  • Обычные (вульгарные) – форма выпукло-округлая, небольшая, телесного цвета, размеры не превышают 3 мм. Поверхность шероховатая. Это самая частая форма – до 70%. В большинстве случаев располагаются на пальцах рук, ладонях, тыльной стороне кистей ввиду частого повреждения либо контакта с потенциально зараженными предметами.
  • Подошвенные — напоминают сухие мозоли, за что имеют название сухих бородавок. Постоянно испытывают давление веса человека, поэтому растут не наружу, а внутрь, в виде шипа. Вследствие этого внутренние повреждаются внутренние ткани и сильно болят. В народе этот вид наростов называют «шпорами» или «шипицами». По мере отвердения боли переходят в хронические.
  • Плоские или юношеские – по цвету мало отличаются от кожи. В основном возникают у детей и подростков на сгибах локтей и коленей, шее, на груди. По форме приплюснуты, незначительно выступают над уровнем кожи, размером не больше 3 мм. Их можно спутать с родинками или веснушками.
  • Остроконечные кондиломы или аногенитальные — возникают при половых контактах и проявляются через несколько месяцев. Инкубационный период длителен.
  • Папилломатозные — растут внутри гортани. При больших размерах могут привести к смерти от асфиксии.

Вульгарные

Причинами таких папилломы становятся 26–29, 41, 63, 77 типы вируса. Новообразования не злокачественные. Сначала на месте будущей возникает дискомфорт в виде зуда и жжение, затем возникают папилломы — шаровидные наросты.

Цвет сначала телесный, потом темнеет. Размер — не более 1 см, шероховатые, немного возвышаются над кожным покровом. Наиболее часто появляются на кистях, бедрах, у грудничков – на коленках. Могут быть одиночными или множественными.

Сухие

Сухая бородавка — нарост на внутренней стороне ладоней, стоп и пальцев. Образования твердые, желтоватого цвета, похожи на мозоли. Вызываются ВПЧ 1, 2 и 4 типов.

Сухие бородавки встречаются чаще у тех, кто носит неудобную обувь или пренебрегает правилами гигиены в общественных местах. Наросты часто болят, чешутся, приводят к изменению походки.

Считая их мозолями, многие к врачу не обращаются. На начальном этапе боль ощущается только при наступании, ходьбе, потом становится постоянной. Подошвенная бородавка всегда имеет несколько черных точек — это запаянные сосуды. На ней нет кожного рисунка — это ее главное отличие от мозоли.

Плоские

Возникают у детей чаще, чем у взрослых. Плоские (внутрикожные) папилломы над кожей практически не выступают, имеют широкое основание. Вызываются 3 и 10 типами. По форме — округлые или овальные образования телесного цвета. Склонны к слиянию. Наросты располагаются на сгибах конечностей, шее, в подмышечной области.

Нитевидные

Имеют тонкую и узкую специфическую ножку. Сначала выглядят, как небольшая шишка, которая вскоре вытягивается. Свисают в виде кожных грибочков телесного цвета.

Вызываются ВПЧ 7 и 2 типов. Появляются после 40 лет. Локализуются на шее, верхних веках, в паху, под мышками, в паховой зоне и под молочными железами. Легко и часто травмируются одеждой или неаккуратными движениями.

Около ногтевые

Околоногтевые бородавки – разновидность простых. Они портят внешний вид рук, хотя угрозы не представляют.

Наиболее часто вызываются вирусом 2 типа. Такие наросты поражают кожу кутикулы ногтя или локализованы под пластиной. Вид имеют неэстетичный, поэтому многие их обладатели стремятся быстрее от них избавиться.

Чаще всего этим заболеванием страдают люди, постоянно кусающие ногти, отрывающие кутикулы и работающие без защитных перчаток в водной среде. Также такие наросты возникают у детей, которые постоянно сосут пальчики.

Старческие кератомы

Себорейный (старческий) кератоз — это возникновение доброкачественных образований на поверхности кожи. Иначе говоря, это не воспалительное усиленное ороговение и утолщение верхнего слоя эпидермиса кожи, которое сопровождается замедлением отшелушивания отмерших клеток.

С возрастом в коже становится меньше коллагена, поэтому она теряет свою эластичность. На ней появляются морщины, она сохнет, трескается. Но этим ее изменения не ограничиваются. С возрастом на коже образуются и пятна: желтые, коричневые, в виде бляшек, наростов и пр.

Они шелушатся, могут зудеть, менять свой цвет и размеры. Обычно такие изменения начинаются уже после 40 лет. Наросты появляются в недоступных глазу местах (спина, шея, голова), симптомов не имеют, и человек их не замечает.

Такие изменения отсутствуют только на ладонях и подошвах. А после 60 лет себорейный кератоз возникает уже у 95% людей. Новообразования могут быть единичными или множественными. Они растут очень медленно, несимметричны, незаразны, редко перерождаются, хотя такая возможность не исключена – 3,3% случаев. Специального лечения чаще не требуется.

Места локализации новообразований

Излюбленная локализация – базальный слой эпителия. Здесь вирус живет и быстро размножается. Благоприятные для него условия — присутствие влаги.

Локализация бородавок практически неограниченно, но быстрее возникают они на тех местах, где возможен контакт с вирусом: пальцы рук и стопы.

Излюбленные места появлений – тыльные поверхности рук, пальцы, межпальцевые промежутки, ладони, стопы, область бороды, волосистая части головы, кайма губ, то есть там, где кожа больше и чаще всего повреждается. Часто бородавки разрастаются на гениталиях – здесь всегда тепло и влажно.

Причины появления, при каких обстоятельствах возникают?

Основная причина – проникновение ВПЧ в поврежденную кожу. Распространенные пути заражения – контактно-бытовый, половой, вертикальный (больная мать заражает ребенка во время родов).

  • ослабление иммунитета; стрессы;
  • психоэмоциональные перегрузки;
  • сахарный диабет;
  • гормональные сбои при беременности и пубертате;
  • курение и алкоголь (доказано, что курение стимулирует рост ВПЧ в шейке матки);
  • посещение скученных мест — бань, саун, пляжей, бассейнов;
  • нарушение личной гигиены, пользование чужими полотенцами или косметикой;
  • авитаминоз;
  • избыточный вес;
  • старческий возраст;
  • повышенное потоотделение.

Признаки заражения ВПЧ

Симптоматика бородавок практически отсутствует. На коже они растут медленно и незаметно. Пациенты обычно обращаются к врачу только при эстетическом дискомфорте.

Признаки поражения могут давать только подошвенные бородавки, другие в случае их травмирования. Бородавки не вызывают симптомов, потому что вирус не проникает в глубокие слои дермы.

Почему нужно обращаться к врачу?

Некоторые типы вируса папилломы человека являются онкоопасными. Наиболее серьезным осложнением является перерождение в злокачественную форму.

Срочное обращение к врачу необходимо, если:

  • имеется рост образования;
  • нарост воспалился, начал кровоточить;
  • образование постоянно подвергается травмированию;
  • зудит;
  • бородавка меняет свой цвет и поверхность, геометрию;
  • имеются признаки нагноения;
  • вы находитесь в группе риска по генетической предрасположенности;
  • образование находится на видном месте и вызывает проблемы, с эстетической точки зрения.

Возможные осложнения

Осложнения могут возникать в случае воспаления часто травмируемых бородавок. Это чревато инфицированием раны. Хирургическое удаление бородавки также может приводить к воспалениям.

Травмированные бородавки могут кровоточить или натираться одеждой. Это может быть результатом трения одеждой, ношения украшений. Малигнизация чаще возникает после 45 лет.

Заключение

Высокий иммунитет прекрасно справляется с ВПЧ. Но как только иммунные функции ослабевают, вирус активируется. Кроме этого, только здоровая чистая кожа может служить надежным заслоном от вируса.

Профилактика может быть специфической и неспецифической. Первый вариант – вакцинация девочкам-подросткам от ВПЧ шейки матки с высокой онкогенностью. Второй вариант – соблюдение мер профилактики правил.

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