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Klinischer Algorithmus zur Therapie von kutanen, extragenitalen HPV-induzierten Warzen

Clinical algorithm of cutaneous extragenital wart treatment

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Zusammenfassung

Verschiedene humane Papillomviren der Genera α-, β-, γ-, μ- und η-Papillomvirus rufen an der äußeren extragenitalen Haut unterscheidbare und typspezifische Warzenerkrankungen hervor. Dornwarzen, auch Myrmecia genannt, Verrucae vulgares und Verrucae planae stellen die häufigsten Krankheitsbilder dar, wobei sich Verrucae vulgares, die durch die nahe verwandten α-Papillomvirustypen HPV 2, 27 und 57 hervorgerufen werden, insbesondere bei multiplem und großflächigem Befall als besonders therapieresistent erweisen. Verschiedene operative, physikalische, chemische oder medikamentöse Therapieoptionen stehen zur Verfügung, aber keine Therapieform verspricht eine sichere Heilung bei allen Patienten. Zur Vermeidung einer zu aggressiven Behandlung ist die Differenzierung zwischen symptomarmen Warzen mit hoher Selbstheilungstendenz, Warzen, die den Patienten akut beeinträchtigen, und Warzen, bei denen eine Selbstheilung nicht absehbar ist, von ausschlaggebender Bedeutung. Induzierender HPV-Typ, Art, Lokalisation, Ausdehnung und Bestandsdauer der Warzenerkrankung wie auch Alter und Immunstatus des Patienten sind Parameter, die die Selbstheilungstendenz beeinflussen und daher bei der Wahl der Therapie berücksichtigt werden müssen.

Abstract

Various human papillomavirus of the genera α-, β-, γ-, μ- and η-papillomavirus induce type-specific extragenital warts. Plantar, common and plane warts are the most common types. The closely related Alpha-papillomaviruses HPV 2, 27 and 57 are responsible for the majority of therapy-resistant common warts. A wide armamentarium of surgical, physical, chemical or drug therapies is available but no modality cures all patients. In order to avoid overtreatment it is mandatory to differentiate between indolent warts which will spontaneously resolve, warts which cause acute discomfort and warts without any tendency to heal spontaneously. HPV type, wart type, localization, size, disease duration as well as age and immune status are parameters influencing self-healing and should be considered when choosing the appropriate wart therapy.

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  1. Hautklinik am Universitätsklinikum der Rheinisch-Westfälischen Technischen Hochschule (RWTH) Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland

    A. Rübben

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Rübben, A. Klinischer Algorithmus zur Therapie von kutanen, extragenitalen HPV-induzierten Warzen. Hautarzt 62, 6–16 (2011). https://doi.org/10.1007/s00105-010-2027-3

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