Papilloma within the mouth. A preventable infection

Human papillomaviruses (HPV) are a part of the Papillomaviridae family, which is able to infecting different species. Greater than 100 varieties of HPV have been described in humans which affect the skin or mucous membranes. In this text, we’re going to take a more in-depth have a look at papilloma within the mouth.

The oropharyngeal region is certainly one of the predominant locations of this virus within the body. The truth is, infections of this kind have increased in incidence lately. What are its predominant causes? How are you going to detect it? Discover here!

In regards to the human papillomavirus (HPV)

HPV has been classified into two predominant groups, depending on the oncogenic capability of the lesions it produces. High-risk viruses are those involved in the event of cancer.

Meanwhile, low-risk HPV includes viruses that cause lesions considered benign, resembling warts or condylomas. Determining the form of virus present in a lesion requires specialized studies.

The causes of papilloma within the mouth

The predominant source of HPV infection is sexual activity. Due to this fact, it’s classified as a sexually transmitted infection (STI). The truth is, it’s the most prevalent viral STI worldwide.

Papilloma within the mouth is less common than within the anogenital region; it results from regular oral sex. As well as, other non-sexual routes of infection are also possible.

In newborns, the birth canal represents probably the most significant source of infection. Likewise, transplacental passage and passage through amniotic fluid are also a possibility.

Alternatively, autoinoculation, wherein a lesion in one body region can function a source of infection at a unique sitehas also been described.

Risk aspects related to oral HPV

Several studies have identified some aspects that increase the probability of HPV infection. Although the literature is more extensive in relation to anogenital infection, papilloma within the mouth can also be related to individual behaviors considered dangerous.

Aside from oral sex, among the aspects involved in HPV transmission are the next:

• Early initiation of sexual activity
• A high variety of sexual partners
• Unprotected sexual activity
• Smoking
• Habitual alcohol consumption
• A history of infection from other varieties of HPV

Gender can also be listed by some authors as a risk factor, since the next frequency of oral HPV is observed in men than in women. Nevertheless, it’s possible that this difference is expounded to higher consumption of alcohol and tobacco in males, in addition to the age of onset of sexual intercourse.

How does HPV infect humans?

Viral particles must enter the epithelium with the intention to infect it. For this reason, it’s been determined that there should be a previous lesion within the skin or mucosa where HPV goes to be situated.

Nevertheless, these wounds are frequently microscopic. Thus, any microtrauma can function a gateway for the virus to contaminate. The oral cavity is a region at risk of any such trauma.

This need for prior injury is because HPV is simply able to infecting cells within the deepest layer of the squamous epithelium, which is present within the skin and mucosa. Due to this fact, it’s only possible to look at papilloma in these locations.

The deeper layers provide cells to the outermost layers, because the basal cells reproduce and migrate to the surface. Thus, an HPV-infected cell progresses through your entire thickness of the epithelium.

Clinical manifestations of HPV within the oral cavity

Normally, HPV infection is asymptomatic and should go unnoticed. Nevertheless, the lesions it produces have characteristics that allow recognition by dentists and physicians. Its predominant clinical manifestations are described below.

Oral papilloma

That is small (lower than one centimeter in diameter) and typically a single lesion. It’s situated on the tongue, taste bud, uvula, frenulum, or vermilion. It has a cauliflower-like appearance, with a pale pink or white coloration.

It’s normally painless and its growth is rapid. It’s attributable to strains with low oncogenic risk. It affects people of any age, but is more frequent between 30 and 50 years of age.

Condyloma acuminatum

This lesion is barely larger than papilloma within the mouth (as much as 3 centimeters). It has a cauliflower-like appearance and will be single or multiple. When the latter occurs, the tendency is to group the lesions together.

Condyloma acuminatum is expounded to subtypes of low oncogenic risk (HPV-6 and HPV-11), however the transmission of this infection occurs sexually.

Multifocal epithelial hyperplasia

In contrast, in multifocal epithelial hyperplasia or Heck’s disease, the lesions usually are not rough, although they do appear raised. The expansion is slow and the coloration will likely be similar to that of the placement.

They’re multiple and typically appear on the lips or on the lateral border of the tongue. It mainly affects children.

Stopping papilloma within the mouth

Because the symptoms can go unnoticed, the prevalence of HPV infection is high, which makes it difficult to take effective measures to avoid infection.

Despite this, the predominant prevention relies on acquiring responsible sexual behavior. On this regard, sexual education at an early age is prime.

Vaccines and papilloma within the mouth

Vaccines have been designed to forestall infection by some varieties of HPV, especially those related to the event of cancer. For that reason, the best effectiveness of their administration is observed before the onset of sexual life, since the potential for having been infected prior to the vaccine is negligible.

The present options for HPV prophylaxis are the next:

• Gardasil, manufactured by Merck Laboratories. It protects against HPV types 6, 11, 16, and 18 and is effective in stopping cancer and warts.
• Cervarix, from GlaxoSmithKline. Provides protection against HPV strains 16 and 18, that are involved in the event of cervical neoplasia.
• Gardasil 9from MSD. It provides immunity against types 6, 11, 16, 18, 31, 33, 45, 52 and 58.

Relationship between HPV and oropharyngeal cancer

HPV is the predominant risk factor for cervical cancer. Nevertheless, it’s also implicated in neoplasms of the anogenital region and the oropharyngeal cavity.

Of the oncogenic HPV types present in squamous cell carcinoma of the top and neck, HPV 16 is probably the most frequent. Nevertheless, unlike cervical cancer, more studies are needed within the oropharynx to ascertain the characteristics of this region.

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