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Background and purpose of genital warts (genital wart GW), also known as venereal warts (venereal wart in) by HPV (human papillomavirus HPV) infection caused by a sexually transmitted disease (sexually transmitted disease STD). The genital warts popular all over the world, is currently the most common sexually transmitted disease in developed countries. 2001 China genital warts in STD's second decline in growth in 2002, is in third place. Genital warts can usually be by the naked eye diagnosis, but need seborrheic keratosis, lichen planus, flat condyloma Bowenoid papulosis and other diseases for early genital warts clinical illegible to the naked eye. Typical lesions can be diagnosed through clinical observation atypical lesions require further confirmed by laboratory tests. Dermoscopy school (dermoscopy) is a non-invasive, in vivo diagnostic techniques used in pigmented skin lesions. The dermoscopy check improve the accuracy of the diagnosis of pigmented skin lesions, but the assessment of the non-pigmented skin lesions is also useful because it can identify not visible to the naked eye or not easy to identify the vascular structure. Our clinical observation Tip: the genital warts may have unique dermoscopic findings, which may contribute to the diagnosis of genital warts,, especially atypical genital warts diagnosis and differential diagnosis. Literature is no description of the relevant the specific dermoscopic standard of genital warts. This study dermoscopy examination of genital warts, describe the dermoscopic characteristics, so as to explore the role of the skin microscopic examination in the diagnosis and differential diagnosis of genital warts. Materials and methods Case April 18, 2006 to 2006, 13 consecutive selected from the outpatient clinic of the Department of Dermatology, the First Affiliated Hospital of Zhengzhou University confirmed by pathology were not treated with medications, laser, or immune therapy 43 male genitalia wart lesions. Outpatient medical records of all cases as a conventional collection complete. Each case lesions using a digital camera (Cyber-shot DSC-F707 and the production of Sony Corporation, Tokyo, Japan), and digital dermoscopy (Dermlite FOTO, 南加里佛尼亚 3Gen, LLC production) shot to take the clinical and dermoscopic school photo, picture description and analysis of dermoscopy by experienced doctors. Results of 1.43 cases were from male patients, the youngest 17 years old, maximum 64 years, an average of 33 years (median). Shortest duration of four days, a maximum of 2 years, an average of 6 months (median). Lesions distributed as follows: 60.47% penis, the pubic symphysis 11.63%, scrotum 9.30%, the glans 4.65%, the Coronal 4.65%, perianal 4.65%, to groin 4.65%. The clinical manifestations of type pimples warts accounted for 36.11%, keratotic warts accounted for 36.11%, 27.78% of genital warts, flat type warts accounted for 16.28%. 2. Skin endoscopic exogenous nipple-like structure in 38 cases (88.37%), 43 cases of genital warts lesions, vascular structures, 36 cases (83.72%). Lesions in 38 cases with exogenous nipple-like structure, mosaic, 14 cases (36.84%), the sample type, 15 cases (39.47%), the mixed nine cases (23.68%). 36 patients with lesions of the vascular structure, punctation 26 cases (72.22%), ring vascular nine cases (25.00%), hairpin blood vessels of 15 cases (41.67%), of thrombotic vascular 12 cases (33.33%). In addition, 20 cases (46.51%) of the lesions of yellow-white keratinized structure, 5 cases (11.63%) of the lesions were homogeneous-like structure and pigmentation, two cases (4.65%) lesions appear sulci brain back to the kind of structure. 3. The dermoscopic findings different clinical manifestations of genital warts: seven cases flat warts, 5 cases showed homogeneous-like structure, the two cases showed a mosaic structure. Three cases in the five cases of homogeneous-like structure visible punctation; two cases of mosaic structure can be seen in two cases punctation and ring vascular. 9 cases of 13 cases papules warts mosaic exogenous nipple-like structures, one cases refers to the sample type, three cases of mixed type, 11 cases punctation; 10 cases of genital warts six cases refers to the kind of exogenous nipple-like structure, 4 cases of mixed the nine cases hairpin blood vessels; keratotic warts in 13 cases, three cases of mosaic exogenous nipple-like structure, the eight cases refers to the kind of type, two cases of mixed yellow-white keratosis structure, punctate vascular embolic vascular five cases. 4.7 cases of flat type warts skin microscope to see the homogeneous-like structure five cases, five cases with its corresponding biopsy showed acanthosis no papillomatosis appear; mosaic type exogenous nipple-like structure of two cases its corresponding biopsy in two cases, both the papillomatosis hyperplasia; vascular structure seen five cases, five cases on its corresponding biopsy dermal blood vessels to dilate. 36 patients with proliferative warts skin microscope to see the exogenous nipple-like structure 36 cases, 36 cases of papillomatosis its corresponding biopsy; 31 cases of vascular structures, its corresponding biopsy dermal vasodilation 24 cases; yellowish-white keratosis structure 20 cases, 20 cases of hyperkeratosis, parakeratosis 18 cases in the corresponding biopsy; pigmentation five cases, its corresponding biopsy pigmentation five cases; sulci gyrus-like structure of two cases, biopsy papillomatosis two cases. Conclusion 1. Genital warts dermoscopy characteristics of the the exogenous nipple-like structure, vascular structures. Exogenous nipple-like structure can be divided into a mosaic, finger-like type and mixed type. Vascular structure including punctate vascular ring vascular hairpin vascular embolic vascular. In addition to the flat-type warts, vascular structures was seen only in the structural unit composed of the exogenous papillary structure. The mosaic exogenous papillary structure often punctation; often like type hairpin vascular; the hybrid often occur punctation, card issuers like vascular ring vascular. In addition, it is also yellow-white keratinized structure, homogeneous-like structure and pigmentation. 2. Flat type warts visible homogeneous-like structure, mosaic exogenous nipple-like structure and punctation; proliferative warts mainly exogenous papillary structures and vascular structures, wherein the papules warts mainly for the mosaic-type structure, punctate blood vessels, some accompanied by pigmentation, yellow-white keratinized structure, embolic vascular; the condyloma performance sample type and mixed type the exogenous nipple-like structure, hairpin vascular ring vascular punctation; keratosis type warts mainly yellow-white keratinized structure and finger-like type exogenous nipple-like structure, embolic vascular hairpin vascular punctation. 3. Dermoscopy findings of genital warts and pathological findings have relevance. 4. Genital warts dermoscopy characteristics contribute to the diagnosis of genital warts, especially in the diagnosis and differential diagnosis of atypical lesions.
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