papiloma

Papilloma refers to a benign epithelial growth that projects from a surface, most commonly caused by infection with human papillomavirus (HPV). Papillomas can occur on the skin or mucous membranes and may be solitary or multiple. They include cutaneous warts (verruca vulgaris and filiform warts), plantar warts, mucosal papillomas of the oral or nasal cavity, and genital warts (condyloma acuminatum). Laryngeal papillomatosis is a notable mucosal form that can affect the airway, especially in children.

Etiology and transmission: HPV types transmitted by direct contact cause these lesions. Low-risk types (such as HPV 6 and 11) commonly produce benign warts and condylomata; high-risk types are associated with malignancies in mucosal sites, though typical papillomas remain benign. Infections are often transmitted through skin-to-skin contact, sexual exposure, autoinoculation, or vertical transmission at birth. Many infections resolve spontaneously, while others persist and recur.

Diagnosis: Diagnosis is usually clinical, supported by histology if needed. Histopathology shows exophytic, papillary fronds of stratified squamous epithelium with fibrovascular cores. HPV testing can be used in selected cases.

Treatment and prognosis: Treatment is often for cosmetic reasons or symptom relief. Options include observation, cryotherapy, surgical excision, laser ablation, or electrosurgery. Topical therapies such as imiquimod or podophyllotoxin are used for mucosal lesions. Recurrence is common, particularly for mucosal papillomas. The prognosis is generally excellent for benign cutaneous papillomas; persistence or high-risk HPV involvement warrants follow-up.

Prevention: HPV vaccination reduces the risk of infection with common high- and some low-risk types and lowers the incidence of related papillomas and cancers. Safe practices can reduce transmission.