Author: Chen Chuxiong
Review: Wu Junyan
Unit: Sun Yat-sen Memorial Hospital of Sun Yat-sen University
Source: Yixian Pharmacy
Mr. Zhang accidentally found a lot of hazel on his hands The small dots are not painful or itchy, Mr. Zhang thought to himself “I’m only in my thirties, how come I have age spots”. So Mr. Zhang went to the hospital for treatment. The doctor’s diagnosis was flat warts, not senile plaques, and he needed to receive treatment as soon as possible. Mr. Zhang thought it was very strange, what caused him to suffer from flat warts? What are the treatments for flat warts? The following Yixian pharmacists will introduce to you.
flat warts are caused byhuman papillomavirus (mainlyHPV3, 5 , 8, 11 and other subtypes) infection caused by viral infectious diseases, when HPV invades the epidermis, the virus replicates and spreads in the epidermal cells, making the granular layer The hyperplasia and vacuolization of the cells of the acanthoid layer and the acanthocytes lead to the large and increased number of local keratinocytes, and the formation of flat papules on the skin surface.
The occurrence and regression of HPV are related to the body’s immune function. important factor in infection. Flat wartsare more common in adolescents and children, and can develop suddenly, starting as fine as a grain of rice and gradually growing to the size of a soybean. clinical manifestationsflat, smooth papules of skin color, pink or brown It is round, oval, polygonal; the number is more or more, the boundary is clear, it can be densely distributed or arranged in a line due to partial scratching, and the adjacent ones can be merged with each other. It usually occurs in the face, hands and neck, and usually has no obvious symptoms. A small number of patients have mild itching and the course of the disease is slow.
Someflat wartspatients get better on their own< /span>, there will be no scars after healing. However, some patients with flat warts have a longer onset time and a larger area of the disease, and are prone to severe pigmentation, which can significantly affect the appearance, especially in the Face, causing great mental stress and emotional impact.
class height =”300″ layout=”responsive” sizes=”(min-width: 320px) 320px, 100vw” src=”https://mmbiz.qpic.cn/mmbiz_jpg/SaicuwDYHXygSSZpIzVtaTh5NHp1Z74daTE97YpZ1oZgAy1ficleUytWfdH4nhL8OSaXzHNyQ364TXgic82E8Vwidth”=”600″>There are two types of treatment for flat warts: Western medicine and Chinese medicine:
Western medicine mostly starts with anti-virus and enhancing immune function. Common drugs such as acyclovir, α-interferon, imiquimod, polycytosine and other antiviral drugs drug. Isotretinoin has anti-abnormal keratinization, immunomodulatory and anti-pigmentation effects on skin cells, and is often used in the treatment of flat warts. Levamisole,Bacille Calmette-Guerin polysaccharide nucleic acid, thymosin, etc. belong to immunomodulatory drugs. Traditional Chinese medicine believes that the disease is caused by the invasion of wind-heat toxin pathogens, or the liver is prosperous and blood is dry, or the qi and blood are stagnant. Such as: purslane, Radix isatidis, Daqingye, Paijiangcao, Coix seed, Salvia, safflower, red peony, comfrey, etc. Modern pharmacology has also confirmed that these drugs have anti-virus, promote blood circulation, improve immunity and so on. For patients with poor efficacy of drug treatment, or longer duration of disease, large distribution area, and darker warts,the use of physiotherapy including cryotherapy and For laser treatment, relevant questions are recommended to consult a dermatologist.
The following are some drugs commonly used for flat warts
For external useisotretinoin preparations such as adapalene or tazarotene gel, oral isotretinoin preparations such as isotretinoin capsules, etc.such Drugs used for the treatment of flat warts are to use their anti-differentiation, anti-proliferation, immune regulation and anti-inflammatory effects. In addition, retinoic acid drugs have a strong keratolytic effect, which can promote the passage of antiviral drugs through the stratum corneum of the wart, so that the flat wart is double disturbed and destroyed .
Special reminder: span>Oral isotretinoin at any dose, even for a short period of time, can cause severe birth defects. Women of childbearing age and their spouses should be strictly contraceptive during and before taking the medicine, within 3 months after stopping the medicine, take a pregnancy test 2 weeks before the treatment, and once a month thereafter , to ensure no pregnancy.
Imiquimod ointment p>
The mechanism of action of imiquimod in the treatment of flat warts is not yet known. Studies have shown that it has no direct antiviral effect on cultured cells, but can induce alpha-interferon on mouse skin. Cytokine production, which may be its antiviral mechanism, however, the clinical relevance of these findings is unclear.
Interferon alpha/2b gel
Recombinant human interferon alpha 2b not only has broad-spectrum antiviral effects, but also inhibits cell proliferation and regulates immunity. The therapeutic effect of interferon on flat warts may involve some or all of the above mechanisms of action.
The antiviral mechanism of acyclovir is mainly through the inhibition of viral DNA polymerase and direct incorporation into the viral DNA chain. Antiviral activity occurs due to the synthesis of viral DNA, but it has no inhibitory effect on viruses that do not replicate in the dormant period. Acyclovir is mainly anti-herpes virus, especially for herpes simplex virus (HSV) type I and type II, and also has a good inhibitory effect on papilloma virus.
Notes1,< span>Flat warts are contagious and can be transmitted through direct or indirect contact. It is more likely to be contagious if the wart is itchy or scratched. Therefore, scratching, friction and irritation should be avoided, and sun exposure should be avoided. 2. Pay attention to the protection of the skin. Trauma can easily lead to virus invasion. Therefore, trauma should be dealt with in time. 3. Keep away from the source of infection, pay attention to hygiene, wash your sheets and covers frequently, and ventilate the room frequently. 4, eat a light diet, eat more fruits and vegetables, eat less seafood, and spicy food. 5, For the treatment of flat warts, it is often difficult to achieve satisfactory curative effect with one treatment alone. Currently, the treatment tends to be comprehensive treatment, such as the combination of oral drugs and external treatment, or Is the addition of physical therapy and so on. If your flat wart has seriously affected your life, it is best to go to the hospital as soon as possible.
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