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The information presented on the site should not be used for self-diagnosis and treatment and cannot serve as a substitute for an in-person consultation with a dermatologist. Epidermodysplasia verruciformis (Lewandowski-Lutz epidermodysplasia verruciformis) is characterized by chronic human papillomavirus (HPV) infection leading to the development of polymorphic skin lesions and a high risk of developing non-melanoma skin cancer. The MoyMinZdrav system allows you to identify a range of diseases and pathological conditions, the likelihood of which is higher with a certain set of symptoms in people of different sex and age.

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The disease occurs in childhood and lasts for years.

Clinical is a rash that looks like flat warts. Their size is quite large. Slightly rise above the surface of the skin. More often these warts are multiple, merge with each other. Merged formations look like plaques. They are located in groups or linearly (in places of injuries and scratching of the skin). The color can be different. from the color of unchanged skin to yellowish or brown. Favorite localization. skin of the face, torso, limbs. If the rashes are localized on the trunk, then in appearance they resemble pityriasis versicolor.

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Differential diagnosis is carried out with pityriasis versicolor, solar keratosis, senile keratoma, skin cancer.

Warty epidermodysplasia is considered an autosomal recessive disease, approximately 10% of patients are children of sick parents, and in 30% the disease is detected in siblings. The disease manifests itself in early childhood. The disease is based on two defining points. In rare cases, the disease is not hereditary (acquired) in persons with severe immunodeficiency. in patients with HIV infection, with immunosuppressive therapy after organ transplantation and other immunodeficiency states. In these cases, the disease manifests itself at any, more often in adulthood, age.

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Malignancy of the process is possible, especially in those places that are subject to friction and insolation. Often has a family character, which does not exclude a genetic predisposition.

Warty rashes in the form of multiple (20 or more), common, slightly elevated papules 3-5 mm in diameter with polygonal outlines, flesh-colored, stagnant red or reddish-brown in color, with a smooth or lobed surface, prone to grouping, linear arrangement and merging into warty plaques). The rash is localized on sun-exposed areas of urso - the face, shins, forearms, when localized on the back of the hands, it resembles flat warts. Rashes of this type, especially if they are caused by HPV types 5, 8 and 14 in patients aged 30 -40 years old, prone to transformation in 50% of cases into Bowen's disease, bowenoid papulosis, basalioma and squamous cell carcinoma.
Large hypo- and hyperpigmented flat plaques and spots that merge with each other, with slight peeling, resembling versicolor and ichthyosis located in the trunk, neck, shoulders and hips. Sometimes light brown areas of pigmentation resembling freckles appear in the face. These rashes are not prone to transformation into malignant diseases.

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In rare cases, there are areas of limited hyperkeratosis, dyschromia, alopecia. Patients are not considered contagious for immunocompetent people. Based on the clinical picture and anamnesis. Histological examination shows acanthosis, papillomatosis, hyperkeratosis, koilocytosis, accumulations of keratohyalin granules, vertical foci of parakeratosis. HPV typing and genetic testing are recommended.

Less often, the process begins with the skin of the face, neck or torso. The number of warts gradually increases, they merge and occupy almost the entire surface of the skin.

Modern methods of family planning also make it possible to establish the presence of pathology in the fetus. With their help, future parents can independently decide on the preservation of pregnancy. The main clinical symptom of Lewandowski-Lutz disease is the generalized formation of flat urso warts on the skin. At first, the elements are small in size (1-5 mm) and occur mainly on the shins, forearms and hands.

If both the father and the mother showed clinically warty epidermodysplasia, then the risk of developing pathology in their children is 100 percent. If two parents are carriers of the disease genes, then the risk of having a sick child is 25%. If one of the parents has a disease, and an absolutely healthy second, then half of the children will be asymptomatic carriers of the pathology gene, and the second part will not inherit it. If only one parent has the gene for Lewandowski-Lutz disease, then none of ursodiol will get sick, but 25% of them will also become asymptomatic carriers.

Lewandowski-Lutz disease is an autosomal recessive disorder that can be passed from parent to child. Usually, if a patient, or his close relatives, has a disease, a genetic consultation is prescribed to study the possibilityawn of manifestation of warty epidermodysplasia in the next generations. There are several options for this situation.

Active infection of the skin with papillomavirus leads directly to the development of pathology, which clinicians divide into two groups. Usually, infection with the virus occurs in early childhood due to the widespread distribution of the pathogen. In 90% of patients, the first symptoms occur before the age of 25. Additionally stimulates the development of warty epidermodysplasia ultraviolet radiation of artificial or natural (sun) origin.

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Pathophysiological mechanisms of development.

In patients with the disease, when exposed to certain viruses, low cellular cytotoxic activity is observed, although the antigen-presenting ability of Langerhans cells is preserved.

The pathology is based on a genetic mutation, which leads to disruption of the normal functioning of protective immune responses.

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Warty elements are removed surgically, cryotherapy, electrocoagulation, photodynamic therapy, lasers - but with all the above methods of removal, relapses occur.

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