How to diagnose cervical warts?

Cervical warts are not unfamiliar to us. They are a very common disease and belong to sexual diseases. Once you feel unwell, you must go to the hospital for examination. The hospital has a certain differential diagnosis for cervical warts. Moreover, with the continuous development of medical technology, the differential diagnosis of cervical warts is no longer a difficult problem. The difficult differential diagnosis can also be carried out from both traditional Chinese medicine and Western medicine. So, what are the diagnostic and differential criteria for cervical warts?

TCM diagnostic criteria

This disease is caused by damp-heat, wind-toxicity and qi-blood stagnation at the junction of the skin and membrane, which leads to warts. Treatment should focus on detoxification. The clinical classification is based on damp-heat, wind-toxicity and other symptoms.

Damp-heat and wind poison

Main symptoms: scattered or fused papillary papules at the junction of the genital membrane, with itching, accompanied by frequent urination, urgency, pain, pus discharge from the urethra and vaginal openings, increased leucorrhea, even purulent. Pale tongue, white fur, floating pulse, or stringy pulse.

Analysis: Damp-heat in the liver and gallbladder, combined with wind-toxicity, damp-heat and wind-toxicity damage the qi and blood, stagnate and do not dissipate, and then warts appear. Damp-heat in the liver and gallbladder, flowing down to the lower jiao, causes itching and pain, stranguria; damp-toxicity interlocks, pus overflows from the urethra, etc. The tongue and pulse are both signs of wind-toxicity on the surface.

Western medicine diagnostic criteria

The following diagnostic criteria can be used for this disease

1. Symptoms: Mild itching and pressure in the vulva.

2. Physical signs: At the junction of the vulvar skin and mucous membrane, there are many light red, dark red or dirty gray wart-like growths on the surface of the lesion, which are uneven and sometimes fused into a cauliflower shape.

3. Pathological examination: Microscopically, the squamous epithelium showed papillary hyperplasia and the spinous cells hyperplasia.

The above three aspects should generally be seen at the same time to make a diagnosis.

Western medicine diagnosis basis

The diagnosis can be confirmed based on medical history, clinical manifestations, physical examination and pathological examination. The diagnosis is mainly based on medical history, other syphilis symptoms, finding Treponema pallidum in local exudate (dark field microscopy), and syphilis serum test. After the diagnosis is confirmed, adequate penicillin treatment is given, and the rash disappears quickly without leaving scars.

Western medicine differential diagnosis

1. Villous labia minora, also known as pseudocondyloma, is common in young women on the inner side of the labia minora, the vaginal vestibule and around the urethral opening. It is a symmetrical, densely distributed, 1-2 mm diameter white or light red papule with a smooth surface. Some may be villous, roe-like or polyp-like. There are no obvious subjective symptoms, but itching occasionally. The acetic acid white test is negative.

2. Pearly penile papules The rash is located at the edge of the coronal sulcus of the glans penis. White, yellowish-white or skin-colored papules of pearly, conical or irregular shapes can be seen. They may be translucent, smooth in surface, hard in texture, and the papules do not fuse with each other. They are regularly arranged in one to several rows along the coronal sulcus. The acetic acid white test is negative.

3. Sebaceous gland ectopia: Millet-sized, isolated and slightly raised, yellow-white or light yellow papules in groups or pieces can be seen on the glans penis, inside the foreskin or labia minora, without any subjective symptoms. Histologically, each papule is composed of a group of small mature sebaceous gland lobules, which surround the sebaceous gland duct. The acetic acid white test is negative.

4. Parafrenulum papular fibroma is a white or yellowish-white millet-sized papule that occurs symmetrically on both sides of the frenulum. It is single or multiple, soft, smooth, and does not fuse. It can be differentiated from cervical condyloma based on medical history and negative acetic acid white test.

5. Lichen lucidus is a shiny polygonal or round flat-top papule that occurs on the penis shaft. It is from the size of a needle tip to a millet grain and can be densely distributed but not fused. Its pathological changes are characteristic.

6. Flat warts are secondary syphilis rashes, which are papules or plaques occurring in the genital area. The surface is flat and moist, and may also be granular or cauliflower-shaped. Treponema pallidum can be detected in dark field examination, and the syphilis serological reaction is positive.

7. Bowenoid papulosis The skin lesions are gray-brown or reddish-brown flat papules, which are mostly multiple and round or irregular in shape. The surface of the papules may be velvety, or slightly keratinized and verrucous. In men, it is more common on the penis, scrotum and glans, and in women, it is more common on the labia minora and perianal area. Generally, there are no subjective symptoms. Histopathological examination is helpful for differentiation.

8. Syringomas appear as small, firm, skin-colored or brown papules, several millimeters in diameter, multiple, and usually asymptomatic. Histopathological examination can confirm the diagnosis.

9. Genital squamous cell carcinoma is more common in people over 40 years old. The lesions are lumps or plaques with obvious infiltration, hard texture, easy bleeding, and often form ulcers. The diagnosis can be confirmed by histopathological examination.

10. Pseudo-condyloma: The lesions are small, miliary-sized, fish-egg-shaped, light red papules or villous changes limited to the labia minora. The surface of the lesions is smooth, the acetic acid white test is negative, and there are no diagnostically significant concave cells in pathology.