papillomen

Papillomas are benign epithelial tumors characterized by finger-like or frond-like surface projections, or papillae, supported by a fibrous core and small blood vessels. They can occur on the skin or mucous membranes and are generally slow-growing. Many papillomas are associated with infection by human papillomavirus (HPV), especially when they appear on mucosal surfaces, but not all papillomas are HPV-related. They can appear as solitary lesions or multiple, and may be pedunculated (on a stalk) or flat (sessile).

Common forms include skin papillomas, such as skin tags (acrochorda), and mucosal papillomas in the respiratory and genital tracts. Laryngeal papillomatosis, often linked to HPV types 6 and 11, can cause hoarseness and airway symptoms and tends to recur after treatment. Sinonasal papillomas arise in the nasal cavity or paranasal sinuses and have a tendency to recur; inverted papillomas particularly carry a higher risk of malignant transformation. Other sites include the urinary tract and oral cavity, where papillomas are typically managed within the context of respective specialties.

Diagnosis usually involves clinical examination and confirmation by histopathology after biopsy or excision. Histological features include papillary fronds of stratified squamous epithelium with a fibrovascular core; koilocytosis may be present if HPV is involved.

Treatment generally consists of removal of the lesion when symptomatic or for diagnostic purposes. Methods include scalpel excision, laser ablation, electrocautery, or cryotherapy. Recurrence is possible, especially for mucosal papillomas or certain locations, and long-term follow-up may be recommended. Overall prognosis is favorable for most cutaneous papillomas, but varies by site and HPV association.