Clasificación por etapas de los condilomas acuminados de la vulva y del tracto anogenital. Una nueva propuesta

Abstract

CONDYLOMATA ACUMINATA, ALTHOUGH NOT A FREQUENT PATHOLOGY, IS USUALLY ASSOCIATED WITH HUMAN PAPILOMA VIRUS (HPV) INFECTION IN VULVAR AND ANOGENITAL TRACT. IT IS ASSOCIATED WITH HPV 6 AND 11. TREATMENT OF CONDYLOMATA LESIONS REDUCES THE RISK OF HPV TRANSMISSION AND THEREFORE THE POSSIBILITY OF SECONDARY NEOPLASIA. HPV VULVAR AND ANOGENITAL TRACT INFECTION HAS THREE STAGES: CLINICAL, SUBCLINICAL AND LATENT. THE CLINICAL STAGE USUALLY HAS DIFFERENT CONDYLOMATA FORMATIONS IN THE VAGINA OR THE KERATIN EPITHELIA. LESIONS ASSOCIATED WITH THE SUBCLINICAL STAGE, MORE FREQUENTLY OBSERVED IN THE CERVIX, ARE ONLY FOUND BY COLPOSCOPY AFTER 5% ACETIC ACID TREATMENT. FINALLY IN THE LATENT STAGE WHICH LACKS MACROSCOPIC LESIONS THE PRIORITY IS TO DETECT VIRAL DNA. BOTH, CLINICAL AND SUBCLINICAL STAGES CAN BE ASSOCIATED WITH BENIGN MORPHOLOGICAL CHANGES SUCH AS CONDYLOMATA LESIONS OR INTRAEPITHELIAL NEOPLASIA. THE AIM OF THIS WORK IS TO PROPOSE A NEW CONDYLOMA LESION CLASSIFICATION BASED ON STAGES WITH THE INTENTION OF SUGGESTING AN ALGORITHM OF THERAPEUTICAL USEFULNESS. OUR PROPOSAL CONSIDERS THE SIZE, NUMBER AND LOCATION OF LESIONS AND IT ALSO RECOMMENDS THREE SUBGROUPS FOR EACH ONE ACCORDING TO CERTAIN WELL DEFINED CHARACTERISTICS MENTIONED IN THE TEXT. WE BELIEVE THAT OUR PROPOSAL IS A PRACTICAL WAY TO CLASSIFY THE CONDYLOMATA LESIONS OF THE LOWER ANOGENITAL TRACT THAT WILL HELP THE CLINICIAN DECIDE A CONVENIENT THERAPEUTICAL APPROACH WITH THE ADVANTAGE OF BEING SIMPLE TO USE.