Ch 79

İnsan Papillomavirüsleri (HPV)

Vol 2 · sayfa 1394 · §12

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Fig. 79.4 Verrucae vulgares (common warts). Courtesy A. Geusau, MD.

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Fig. 79.4 Verrucae vulgares (common warts). Courtesy A. Geusau, MD.

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Fig. 79.5 Periungual common warts. Destruction of the nail matrix and bed can lead to partial (A) or complete (B) absence of the nail plate. Bowen disease may be considered in the differential diagnosis, especially for a single, recalcitrant digital wart.

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Fig. 79.6 Verrucae plantares (plantar warts). The photo was taken after shaving of the hyperkeratotic surface; the black dots represent hemorrhage into the stratum corneum.

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Fig. 79.7 Multiple filiform warts on the lower face.

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Fig. 79.8 Myrmecial wart. The wart at the base of the distal phalanx of the hallux is painful due to deep endophytic growth; in addition, there are confluent plaques of superficial warts (mosaic warts).

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Fig. 79.9 Extensive and chronic verrucosis of the soles in a patient with hepatic cirrhosis due to alcoholism. HPV-27 DNA was isolated from the lesions.

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Fig. 79.10 Verrucae planae (flat warts). Multiple skin-colored or pink (A, B) to brown (C) smooth-surfaced, flat-topped papules. (D) Thin pink papules and plaques that are well demarcated and have more scale than the patients in A-C. These lesions are typically caused by HPV-3 or -10. B, Courtesy Kalman Watsky, MD; C, Courtesy Julie V. Schaffer, MD.

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Fig. 79.10 Verrucae planae (flat warts). Multiple skin-colored or pink (A, B) to brown (C) smooth-surfaced, flat-topped papules. (D) Thin pink papules and plaques that are well demarcated and have more scale than the patients in A-C. These lesions are typically caused by HPV-3 or -10. B, Courtesy Kalman Watsky, MD; C, Courtesy Julie V. Schaffer, MD.

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Fig. 79.10 Verrucae planae (flat warts). Multiple skin-colored or pink (A, B) to brown (C) smooth-surfaced, flat-topped papules. (D) Thin pink papules and plaques that are well demarcated and have more scale than the patients in A-C. These lesions are typically caused by HPV-3 or -10. B, Courtesy Kalman Watsky, MD; C, Courtesy Julie V. Schaffer, MD.

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Fig. 79.11 Epidermodysplasia verruciformis (EV). A Confluent scaly papules and plaques resembling flat warts. B Numerous hypopigmented and light pink, flat-topped papules, some of which are in a linear array, in acquired HIV-associated EV. B, Courtesy Ncoza Dlova, MD.

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Fig. 79.11 Epidermodysplasia verruciformis (EV). A Confluent scaly papules and plaques resembling flat warts. B Numerous hypopigmented and light pink, flat-topped papules, some of which are in a linear array, in acquired HIV-associated EV. B, Courtesy Ncoza Dlova, MD.

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Fig. 79.12 Epidermodysplasia verruciformis. Generalized erythem- atous macules and plaques are seen in the same patient as shown in Fig. 79.11A. Lesions tested positive for HPV-8 and -36.

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Fig. 79.13 Condylomata acuminata. Verrucous lesions on the glans and in the sulcus, with a few small papules on the shaft of the penis and distal glans. Note the acuminate topog- raphy, i.e. the tapering to a point. Courtesy Lorenzo Cerroni, MD.

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Fig. 79.13 Condylomata acuminata. Verrucous lesions on the glans and in the sulcus, with a few small papules on the shaft of the penis and distal glans. Note the acuminate topog- raphy, i.e. the tapering to a point. Courtesy Lorenzo Cerroni, MD.

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Fig. 79.14 Condylomata acuminata. A Confluent lesions forming hyper- pigmented plaques in the perineal region and along the inguinal fold. A depigmented scar is seen at the site of prior treatment with liquid nitrogen. B Large, exophytic, broad-based or pedunculated papil- lomas in a healthy 15-year-old boy. The differential diagnosis includes Buschke- Löwenstein tumor.

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Fig. 79.16 Bowenoid papulosis of the anus positive for high-risk mucosal HPV in a man who had sex with men. Histology revealed high- grade anal intraepithelial neoplasia (AIN), not invasive SCC. However, continued monitoring is indicated.

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Fig. 79.17 Erythroplasia of Queyrat. A well-demarcated velvety plaque of the prepuce positive for high-risk HPV; histology revealed high-grade penile intra epithelial neoplasia (PIN).

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Fig. 79.17 Erythroplasia of Queyrat. A well-demarcated velvety plaque of the prepuce positive for high-risk HPV; histology revealed high-grade penile intra epithelial neoplasia (PIN).

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Fig. 79.18 Giant condy- lomata acuminata (Buschke–Löwenstein tumor). Cauliflower-like, deeply infiltrating giant condylomata acuminata in an older woman.

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Fig. 79.20 Oral warts. Papillomas of the labial mucosa in a 6-year-old child.

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Fig. 79.21 Verruca vulgaris – histopatho- logic features. Note the characteristic features of “church spire” papil- lomatosis heaped with ortho- and parakeratosis, acanthosis, hypergranu- losis, and koilocytosis. Courtesy R. Tyler, MD.

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Fig. 79.21 Verruca vulgaris – histopatho- logic features. Note the characteristic features of “church spire” papil- lomatosis heaped with ortho- and parakeratosis, acanthosis, hypergranu- losis, and koilocytosis. Courtesy R. Tyler, MD.

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Fig. 79.24 Invasive squamous cell carcinoma of the penis. It developed over more than a decade from a papular lesion of the prepuce. HPV-16 and -51 DNAs were detected by RT-PCR.

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Fig. 79.25 Proliferative verrucous leukoplakia of the oral cavity. The lesions have focally progressed to invasive squamous cell carcinoma; HPV DNA was not detectable by PCR.

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