GENITAL WARTS

Genital warts may present as small, flat, fleshy- coloured bumps or tiny ,cauliflower-like bumps caused by Human papilloma virus(HPV). Over 100 types of HPVs infects humans, however the common ones known are associated with cancer of the vulva,anus and penis.

Genital warts vary in size. Some are even so small that you can’t even see them.

PATHOPHYSIOLOGY

It is acquired by inoculation of the virus into the epidermis via defects in the epithelium (eg, maceration of the skin ,trauma or abrasions. In immunocompetent patients, most genital HPV infections are spontaneously cleared by the host immune defense mechanisms. 10% to 30% of genital warts resolve in 3 months of onset without treatment.The incubation period ranges from 2 weeks to 8 months or even longer.SYMPTOMS

In women, genital warts can grow on the vulva, the walls of the vagina, the area between the external genitals and the anus, the anal canal, and the cervix. In men, they may occur on the tip or shaft of the penis, the scrotum, or the anus. Genital warts can also develop in the mouth or throat of a person who has had oral sexual contact with an infected person.

The signs and symptoms of genital warts include:

*Small, flesh-colored or gray swellings in your genital area

*Several warts close together that take on a cauliflower-like shape

*Itching or discomfort in your genital area

*Bleeding with intercourse

SYMPTOMS (Men)

Men most often have warts on the penis, scrotum,anus, and around the thighs as well.

Both males and females can have warts in and around the mouth, lips, throat, tongue and palate.

MANAGEMENT/TREATMENT

*Surgical excision (cutting them out)

*Condoms should be used for up to 8 months after treatment. *Soft parrafin should be applied on surrounding skin as protection due to absorption/toxicity.

CANDIDIASIS

Candidiasis ( thrush or moniliasis) is a fungal infection or mycosis caused by candida albicans.Candida  infections range from superficial, such as oral thrush and vaginitis, to systemic and potentially life-threatening diseases.Systemic  Candida (candidemia) are usually confined to severely immunocompromised persons, such as cancer, transplant, and AIDS patients etc.

Normal vaginal flora consist of microbes like candida albicans and lactobacillus spp. It has a pH  of about 3.5 to 5.5 .Candida  overgrowth is maintained by the immune system and microbes(lactobacillus). Disturbance in the normal vaginal flora causes the disease.

RISK FACTORS

*Menstruation , pregnancy and menopause*Oral contraceptives / antibiotics*Diabetes *Tampons , synthetic underwear, tight clothing*Multiple or new sexual partners, * Vaginal douching.

*Hormone replacement therapy may also play a part in predisposition to the condition.

SYMPTOMS*Candidiasis – A white , lumpy or thick discharge ,usually accompanied by itching in females*Males are usually asymptomatic but are believed to cause reinfection .

 PREVENTION

*Wear cotton underwear*Avoid vaginal touching, vaginal sprays or antibacterial soaps in the vagina*Always wipe from front to the back after using the washroom*Avoid tight jeans and pants for long periods.*During menses change tampons regularly*Use condom        

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