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A 67-year-old female presented to the Dermatology Department with a tumor formation located on the left lateral side wall of the nose, measuring 1,5/1,2 cm in size, which had been slowly growing over the past few years. The tumor exhibited a shiny, pink-colored surface with a dome-shaped appearance, irregular borders, and superficial telangiectasias, raising clinical suspicion for basal cell carcinoma. Additionally, there was no reported history of skin cancer in any family member or painful sunburns during childhood. The patient was recommended surgical excision under local anesthesia for the suspected lesion.

A 75-year-old female presented to the dermatology department with primary complaints of a tumor formation located in the center of the forehead, above the eyebrows. The adjacent skin was slightly sun damaged but no signs of surgical scars or malignancy were noted. A clinical diagnosis of basal cell carcinoma was established, and the patient was recommended surgical excision under local anesthesia.

A 74-year-old male presented to the dermatology department with tumor formation located in the left auricle area, measuring 2 cm in size. The tumor exhibited surface erosions and periphereal erythema. Additionally, in the right lower eyelid and temporal regions, clinically suspected lesions for squamous cell carcinomas were noted. [...]

An 80-year-old female presented with an atrophic lesion in the area of the nasal apex, dating for the past 5-6 years. The lesion had a superficial telangiectasias and a pearly edge, measuring 1 cm in diameter. The patient denies painful sunburns in the past. Previous history of basal cell carcinomas located on the temporal and sacral regions. [...]

The problem of drug-induced cancers, and in particular skin cancers after intake of various antihypertensive drugs, is increasing, but at the same time is gaining some clarity. In addition to melanocytic cancers, development of keratinocytic cancers is increased after the administration of sartans. It is believed that the procarcinogenic potential of the medication could be due to contamination of tablets with nitrosamines, which are known as mutagens. Regardless of the presence of angiotensin receptors in the skin and tumor tissue, the pharmacologic influence of the sartan is considered to be secondary and insignificant in relation to the processes of carcinogenesis. In certain cases, this influence is even defined as an antitumorous effect. We present a female patient who had been taking telmisartan/amlodipine 80/5 mg daily for 9 years and, after 4-5 years, developed a scalp tumor, confirmed histopathologically as a basal cell carcinoma (BCC) and treated successfully by surgical excision. The discussion is mainly focused on the potential role of nitrosamines as a new key player in the pathogenesis of keratinocytic cancers and BCC in particular.

Giant keratinocyte tumors, in particular basal cell carcinomas of the scalp area, are a serious challenge for dermatosurgeons, oncologists, maxillofacial and reconstructive surgeons. The scalp area is limited in terms of skin mobility, and its elasticity decreases with age. The size of the tumors in this area and the degree of infiltration of the underlying tissues are important for the therapeutic choice - from surgical removal, waiting for granulationsto form and placing a split skin mesh graft (at a later stage), to performing complex rotational/transpositional or progressive flaps. Achieving an optimal aesthetic result is often the result of interventions carried out or based on the decisions of multidisciplinary teams. Alternatives such as radiotherapy and targeted therapy with vismodegib, for example, could be administered both preoperatively and postoperatively or as first-line therapy depending on tumor board decisions. We present a 69-year-old female patient with histopathologically proven preoperative giant basal cell carcinoma of the scalp that did not involve the tabula externa. Surgical treatment under general anesthesia was planned. A preoperative ultrasound was performed due to the repositioned area and the preservation of the feeding arteries. During the operation, the resection lines were in close proximity, but did not affect the arterial vessels. After applying the rotational advancement flap technique, under general anesthesia, an optimal cosmetic effect was achieved.

Genital melanocytic lesions can be quite difficult to distinguish due to the close proximity of the clinical findings. Melanocytic lesions, especially in delicate anatomical locations such as the vulva, penis, mons pubis etc, are even more challenging to diagnose. The patients may delay physical examinations due to anxiety or discomfort from the location of the lesion. In terms of therapy options, the surgical approach is not always the preferred one, but it is the one that could lead to a definitive solution to the problem. A limited number of studies in the medical literature do not exclude the fact that atypical nevi of genital type could also be considered as melanoma precursors. Single case reports have identified atypical genital nevi of the labia majora as a risk factor for genital melanoma development. Lesions that occupy a larger area than the labia majora and extend into the areas around them are particularly problematic. Precisely because of this fact, the result of a single biopsy could be false and misleading. Therefore, careful physical and repeated preoperative histological examinations are mandatory. Mechanical irritation in the genital area, and in particular in the labia majora region, is an additional reason for choosing the surgical-reconstructive therapeutic option. We present a 13-year-old female with a progressive “kissing” divided nevus from genital type (AMNGT) , located in the area of the vulva and labia majora, extending to the mucosa. A biopsy was taken in order to rule out malignancy. Immunohistochemistry was performed with specific melanocyte markers S-100, HMB-45 and SOX confirming the benign origin of the lesion. A diagnosis of atypical melanocytic nevus of genital type (AMNGT) was made. For prevention a surgical excision was advised but later on declined by the patient’s parents. Further close observation of the lesion was recommended.

Post-vaccinal and parainfectious activation of the immunity with subsequent development of a certain immunological/skin-immunological disease isn’t rare in the clinical practice. This concept is mentioned in relation to molecular/antigenic mimicry. To this day, the pathogenesis of sarcoidosis and sarcoid-type reactions remains a mystery. Moreover, they can be a warning sign of changes in tissue homeostasis, whether it is infectious, non-infectious-immunological, tumor-related, etc. We present a rare form of erythrodermic sarcoidosis with massive systemic involvement (pericarditis, supraventricular tachycardia, hepatitis, iritis/iridocyclitis, pulmonary fibrosis/bihilar lymphadenopathy, and arthritis) developed after receiving the ChadOx1-S vaccine for Covid-19. Systemic immunosuppressive therapy with Methylprednisolone was introduced according to a scheme (in a reduction mode with an initial dose of 40 mg/day intravenously) in combination with: topical Pimecrolimus 1% cream twice a day. Rapid improvement of the symptoms was observed within the first two days of treatment. According to the references in the scientific literature, the presented patient turns out to be the first case of erythrodermic sarcoidosis (with systemic involvement), described as a side effect after vaccination and/or administration of a certain medicinal form.

A 41-year-old female presented in the dermatology department with primary complaints, dating for 2 months, of occasionally appearing and disappearing itching rashes over the whole body [...].

The potential or actual contamination of widely distributed medications with nitrosamines is currently a serious problem. Medications, such as ranitidine, metformin, rifampicin, hydrochlorothiazide, angiotensin-converting enzyme (ACE) inhibitors, and sartans, used as monotherapy or in combination with other drug classes, practically contain ingredients potentiating tumor generation and tumor progression. The dilemma with the ˝increased availability˝ of nitrosamines concerns the subsequent development not only of single but also of multiple skin tumors, sometimes even in combination with other tumor types. The development, in particular, of keratinocyte tumors after administering drugs such as sartans, hydrochlorothiazide and ACE inhibitors has been described repeatedly over the past 7 years. Data on these types of tumors have been officially published not only in a number of large-scale european and american retrospective analyzes but also in the form of dozens of case studies with a retrospective/prospective nature. We describe the case of a patient who developed a basal cell carcinoma (BCC) of the chin, which enlarged significantly after taking potentially nitrosamine-contaminated metformin. The role of nitrosamines as a possible key factor in tumor development is discussed.

Epithelial tumors, and in particular basal cell carcinoma (BCC), extremely rarely affect the area known as Cupid’s bow, and their treatment remains a serious challenge. We present a 53-year-old patient with a history of painful sunburns in the past and BCC of the neck, successfully treated surgically. The reason for the hospitalization was the appearance of a new nodular achromic lesion in the area of ˝Cupid’s bow˝ (upper lip), which preoperatively was verified histopathologically as BCC. Elliptical excision under local anesthesia was performed, and the resulting defect was closed using an undermining surgical approach, followed by single skin sutures. The patient’s 4-month follow-up was uneventful with no evidence of recurrence. Treatment options for BCCs in the area of Cupid’s bow and the advantages of elliptical excision in the area are discussed.

Since the alarming, yet prudent publication of the possible association of sartan use and development of various cancers in 2010, anti-hypertensive drugs (sartans and thiazide diuretics) have been closely monitored by various scientific and drug authoritarian bodies around the world. Fast forward 12 years, the number of scientific publications showing an increased risk of developing various types of cancer, including skin cancers, after sartan and/ or hydrochlorothiazide use is on the rise. Case description: A 77-year-old male with arterial hypertension under treatment for approximately 3 years (2018-2022) with three different preparations containing sartans in combination with hydrochlorothiazide was observed with a pigmented lesion present on the left cheek for 2 years with clinical and dermatoscopic suspicion of lentigo maligna, confirmed by histopathology. Further three suspected dysplastic naevi were also identified on the back, two of them confirmed by histopathology. Possible drug-induced melanocytic lesions were suspected and his drug regimen was changed. The prognosis was favorable with a good post-operative outcome. Conclusion: The amount of data linking the use of hydrochlorothiazide alone or in combination with sartans and the development of melanomas or their precursors, is worrying. Given the additional disclosure of pharmaceutical companies about the existing elevated concentrations of nitrosamines in these two classes of antihypertensive drugs, the establishment of a causal relationship between the intake of a particular carcinogen and the development of a tumor or tumor precursor requires careful and detailed scrutiny. The extent to which sartan/hydrochlorothiazide used and the occurrence of the lentigo maligna, especially when shared data points in this direction, remains unclear. However, in clinical practice, it should be highly recognized.

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Erosive pustular dermatosis of the scalp (EPDS) is a rare condition which affects predominantly the adult population, and occurs on a previously photo-damaged bald scalp. The physical examination is presented with a large erythematous, erosive and crusted patches with granulation on an atrophic skin. The problem in patients with erosive pustular dermatosis of the scalp arises from the nonspecific clinical and histopathological findings, which can be misleading. Biopsy followed by careful histopathological verification is mandatory, although the finding is nonspecific.The histopathology findings are characterized by superficial erosions with mild neutrophil infiltrate, mainly intravascular and focally with neutrophil exocytosis. Focal parakeratosis, smoothed rete ridges without pronounced interface changes. Pronounced lymphoplasmacytic infiltrate with focal distribution in the dermis, giant cell reaction with the formation of a “foreign body” granuloma. We report a 58-year old male patient with a 1 year old lesion, suspected for skin cancer, later diagnosed with EPDS, which was successfully treated with topical clobetasol proprionate after 3-5 weeks.

Although described as early as 1975 as a distinct, rare form of cancer with diverse localization, primary cutaneous adenoid cystic carcinoma (PCACC) remains a mystery and challenge for both clinicians and pathologists. The clinical presentation cannot be clearly distinguished from amelanotic melanoma or intradermal nevus, Merkel cell carcinoma, trichofolliculoma, trichoepithelioma or other rare tumors of the adnexa, or dermatofibrosarcoma protuberans. The histopathological diagnosis requires not only careful evaluation of standard hematoxylin / eosin preparations, but also immunohistochemical staining with a number of markers such as epithelial membrane antigen (EMA), S-100, SOX-10, Ki-67, CD-117 (c-kit), Vimentin, carcinoembryonic antigen (CEA), Ber-EP4 and many others. The surgical approach should consist of excision with margins between 1 and 2 cm, with the choice of margins depending upon the histopathological findings in the primary excisional specimen. We present a 31-year-old patient with an enlarging, amelanotic, plaque-like tumor of the scalp with a duration of no more than 18-24 months. Surgical treatment was performed within two surgical sessions with a total resection field of 1.3 cm. A good cosmetic result was achieved.

Tumors of the scalp remain a serious challenge for clinicians since poor locoregional skin elasticity hinders the ability to utilise certain flaps, limiting the choice of reconstructive techniques available. As a result, surgical restoration of medium to large-sized defects are left to the discretion of the surgeon, who with a comprehensive knowledge of restorative techniques, along with the advantages, limitations as well as a sound understanding of the locoregional anatomy, can make thorough decisions on the choice of which flap is best suited for the defect. Here we present two cases where the double hatchet flap was employed as a dermatosurgical approach in order to provide exceptional cosmetic results. On dermatological examination, both patients presented with a medium to large- sized tumour formation but were otherwise in good health. Both underwent radical, widelocal excision, followed by reconstructive manipulation in the form of a double hatchet flap to close the defect. Postoperative follow-up reported positive signs of wound healing with aesthetically pleasing results. Finally, we discuss the use of various flaps in such conditions while providing evidence for the double hatchet flap as a possible alternative that provides perfect aesthetic results as seen in our cases. Such a complex surgical intervention requires the expertise of a multidisciplinary team in order to achieve an overall successful outcome.

We present an 80-year-old patient with a fast-growing lesion on the lower lip, lasting for no longer than one year. The clinical examination revealed the presence of endophytically growing tumour formation along almost the entire length of the lower lip, associated with spontaneous bleeding as well as severe pain on palpation.

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Introduction: Giant basal cell carcinomas (GBCCs) are extremely rare and typically more aggressive than their predecessor subtype. GBCCs with mushroom-like morphology have rarely been reported, with only one other case identified in the literature. Here we present a unique case of a neglected giant mushroom-like BCC that was treated successfully. Case description: An 81-year-old male patient presented with a large ulcerative mass on his back. He had a medical history of chronic heart failure and atrial fibrillation, which were controlled with heart medication. During a routine visit to change the dressing of the lesion, the central pedunculated stalk underwent spontaneous haemorrhaging which led to massive blood loss. The patient was treated for shock and the lesion was completely excised under emergency surgery. The tumour was sent for histopathological assessment after complete surgical removal. Recovery was successful with good postoperative results and no recurrence was reported in the 12 months following discharge. Discussion: The patient was under long-standing anticoagulant therapy that contributed to the untimely rupture of the pedunculated lesion and led to spontaneous heavy haemorrhaging. Treatment for such giant lesions can be complex, especially in patients with co-morbid conditions. Careful assessment and early treatment are paramount for successful results. Conclusion: Complete removal of such lesions is very successful for treating GBCCs.

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Methotrexate is a systemic immunosuppressant drug that is used for the treatment of psoriasis and psoriatic arthritis. Previous studies demonstrated a potential association between psoriasis and diabetes mellitus, obesity, atherosclerosis and hypertension. This study aimed at exploring the possible hyperglycaemic effects of methotrexate in psoriatic arthritis (PsA) patients. In this prospective cross-sectional study, 27 patients with PsA were evaluated. The status of PsA and presence of accompanying metabolic syndrome was determined by standard criteria and indexes. Blood indicators including, HbA1c, erythrocyte sedimentation rate, fasting blood sugar, total cholesterol, high-density lipoprotein, triglycerides, and C-reactive protein were examined before and 12 weeks after methotrexate therapy. There were no significant changes between HbA1c levels before and after methotrexate therapy in both genders (men: P=0.131, women: P=0.803). In addition, HbA1c levels in PsA patients with metabolic syndrome were not different before and after treatment (P=0.250). Finally, HbA1c levels did not change in PsA patients without metabolic syndrome before and after therapy (P=0.506). Methotrexate in PsA patients does not appear to have hyperglycaemic effects in the short-term and can be safely used in patients with metabolic syndrome and diabetes.

Tinea capitis is generally considered as the most frequent fungal infection in childhood, as it accounts for approximately 92% of all mycosis in children. The epidemiology of this disease varies widely ranging from antropophillic, zoophilic, and geophillic dermatophytes, as the main causative agent in different geographic areas, depending on several additional factors. Nowadays, the etiology is considered to vary with age, as well with gender, and general health condition. The former reported extraordinary Tinea capitis case reports have been replaced by original articles and researches dealing with progressively changing patterns in etiology and clinical manifestation of the disease. This fact is indicative that under the umbrella of the well-known disease there are facts still hidden for future revelations. Herein, we present two rare cases of Tinea capitis in children, which totally differ from the recently established pattern, in their clinical presentation, as well as in the etiological aspect, as we discuss this potential new etiological pattern of the disease, focusing on our retrospective and clinical observation. Collected data suggest that pathogenic molds should be considered as a potential source of infection in some geographic regions, which require total rationalization of the former therapeutic conception, regarding the molds’ higher antimitotic resistance compared to dermatophytes. Molds-induced Tinea capitis should be also considered in clinically resistant and atypical cases, with further investigations of the antifungal susceptibility of the newest pathogens in the frame of the old disease. Further investigations are still needed to confirm or reject this proposal. Keywords: Tinea capitis, Children, Etiology, Molds

Aquagenic keratoderma has been described as a transient condition affecting predominantly young females and defined clinically by the appearance of palmar hyper-wrinkling accentuated after immersion in water. We present two new cases with aquagenic palmoplantar acrokeratoderma - a child and a young male. A significant clinical improvement was achieved after topical treatment with aluminum salts. Aquagenic palmar keratoderma may be a clue to cystic fibrosis in adolescents and young adults. We developed a new hypothesis on its pathogenesis.

The primary cutaneous T-cell lymphomas (CTCL) represent a clonal T-lymphocyte proliferation infiltrating the skin. CD30+ T-cell lymphomas present clinically as nodules with a diameter between 1 and 15 cm, mostly in elderly patients. The role of the CD30 molecule in patients suffering from T-cell lymphomas is not completely clear yet. The signal transduction pathway which includes CD30 seems to play a key role in tumor progression. In certain forms of T-cellular lymphomas, the interaction between CD30/CD30-ligand is able to provoke apoptosis of the "tumor lymphocytes". The modern conceptions of the pathogenesis of T-cell lymphomas include disorders in the pathways involved in programmed cellular death and disregulation in the expression of certain of its regulatory molecules. We are presenting an unusual case of a female patient with a primary cutaneous form of CD30 + /ALK− anaplastic large T-cell lymphoma. Upon the introduction of systemic PUVA, (psoralen plus ultraviolet light radiation) combined with beam therapy, a complete remission could be noticed. Eight months later, we observed a local recurrence, which was overcome by CHOP chemotherapy (Cyclophosphamide, Hydroxydaunorubicin (Doxorubicin), Vincristin (Oncovin®), Predniso(lo)n). Six months later, new cutaneous lesions had been noticed again. A new therapeutic hope for the patients with anaplastic large CTCL is actually based on the influence of the activity of the different apoptotic pathways. Death ligands, including tumor necrosis factor (TNF)-α, CD95L/FasL, and TRAIL, mediate also some important safeguard mechanisms against tumor growth in patients with CD30 + cutaneous anaplastic large T-cell lymphomas and critically contribute to lymphocyte homeostasis.

Lymphogranuloma venereum is an infection caused by a variety of the bacterium Chlamydia trachomatis. Both genital and extragenital manifestations of the disease can cause serious differential diagnostic difficulties, indirectly leading to progression and dissemination of the infection. This work describes cases of patients with lymphogranuloma venereum showing atypical clinical and/or histopathological findings. It also focuses on alternative therapeutic approaches, such as surgical excision at stage 1, that may lead to a positive outcome. It is not completely clear whether histopathological findings of lymphogranuloma venereum can reveal progression or changes in the course of the disease over time, as is the case in other diseases. We conclude that both clinical and histopathological observations in a larger number of patients are needed in order to further evaluate the findings presented in this article.Linfogranuloma venéreo é uma infecção causada por um tipo específico da bactéria Chlamydia trachomatis. Manifestações genitais e extragenitais da doença podem causar uma série de dificuldades no diagnóstico diferencial, indiretamente levando a progressão ou disseminação da infecção. Este trabalho apresenta casos de pacientes com linfogranuloma venéreo cujos achados clínicos e/ou histopatológicos são atípicos, além de abordar métodos de terapia alternativos, tais como excisão cirúrgica na fase 1, os quais podem trazer um resultado positivo. Ainda não se sabe se achados histopatológicos do linfogranuloma venéreo podem revelar progressão ou mudanças no curso da doença ao longo do tempo, como ocorre com outras enfermidades. Concluímos que observações clínicas e histopatológicas devem envolver um número maior de pacientes a fim de avaliar os resultados clínicos deste trabalho.

Apoptotic pathways are providing important saveguard mechanisms in protection from cancer by eliminating altered and often harmful cells. The disturbances of cell proliferation, differentiation and apoptosis are also found on specific signal-transduction pathways within the tumour cells and between these and the immune system. The article focuses attention on the evolution of the melanocytic naevi in the direction of a dysplastic or tumour cell. The determination of single molecules as prognostic parameters within cancer genesis seems to be problematic. New hopes are being placed on the treatment with TW-37, ABT-737 and TAT-Bim, which, to an extent, are able to support the programmed cell death. The clinical importance of these innovative therapies remains to be seen and should therefore, be viewed with considerable criticism.Caminhos apoptóticos estão fornecendo importantes mecanismos de salvaguarda na proteção contra o câncer através da eliminação de células alteradas e freqüentemente nocivas. Os distúrbios de proliferação, diferenciação e apoptose celular são também encontrados nos caminhos específicos sinal-transdução dentro das células tumor e entre essas células e o sistema imunitário. O artigo foca na evolução da verruga conhecida como melanocytic naevi em direção a uma célula displasica ou célula tumor. A determinação de moléculas isoladas como parâmetros de prognóstico dentro da gênesis do câncer parece problemática. Novas esperanças estão sendo colocadas no tratamento com TW-37, ABT-737 e TAT-Bim, os quais, até certo ponto, são aptos a apoiar a morte celular programada (PCD). A importância clínica dessas terapias inovadoras permanece ainda a ser vista e devem, por essa razão, serem olhadas com considerável juízo crítico.

Literature data analysis, providing an exact explanation of the lichen planus pathogenesis, as well as its transition into other rare forms such as Keratosis lichenoides chronica or Graham Lassueur Piccardi Little Syndrome are scant, or totally missing. The chronological course of the disease, known in the literature as lichen planus, varies. Some patients develop Lichen planus or lichen nitidus and there is no logical explanation why. It is also not clear why single patients initially develop ulcerative lesions in the area of the mucosa and only in a few of them these lesions affect the skin. Antigen Mimicry and Epitope Spreading could be the possible pathogenic inductor in cases of lichenoid dermatoses, as well as the cause for their transition into ulcerative, exanthematous or other rare forms. The Epitope Spreading is probably not the leading pathogenetic factor in lichen planus but a phenomenon which occurs later. This manuscript analyzes some basic pathogenic aspects and presents some possible medical hypotheses regarding the heterogenic clinical picture and pathogenesis of lichen planus and lichenoid like pathologies of the skin which, in the near future should be analyzed in details in order to clarify several dilemmas the clinical dermatologist has to face.Análises das informações disponíveis na literatura que forneçam uma explicação precisa sobre a patogênese do Líquen Plano, assim como sobre sua transição para outras formas raras da doença, como Ceratose Liquenóide Crônica ou Síndrome de Graham-Little-Piccardi- Lassueur , são raras ou inexistentes. O curso cronológico da doença, conhecida na literatura como Líquen Plano, varia. Alguns pacientes desenvolvem Líquen Plano ou Líquen Nítido e não ha uma explicação lógica do por quê. Também não está claro por que alguns pacientes inicialmente desenvolvem lesões ulcerativas na área da mucosa e em apenas alguns deles essas lesões afetam a pele. Mimetismo Antigênico ou Espalhamento de Epítopos poderiam ser fatores patogênicos indutores em casos de Dermatoses Liquenóides, e também fatores responsáveis pela transição para a forma ulcerativa, exantematosa ou outras formas raras da doença. Espalhamento de Epítopos provavelmente não é o principal fator patogênico envolvido no Líquen Plano, mas um fenômeno de ocorrência posterior.Esse manuscrito analisa alguns aspectos patogênicos básicos e apresenta algumas hipóteses médicas sobre o quadro clínico heterogênico e a patogênese do Líquen Plano e de patologias da pele do tipo liquenóide. Essas patologias devem, em um futuro próximo, ser analisadas minuciosamente a fim de esclarecer vários dilemas que o dermatologista clínico tem de enfrentar.

The family of human papilloma viruses (HPV) comprises more than 100 genotypes. Approximately 30 of the genotypes are responsible for infections in the human anogenital area. A precisely defined algorithm with the goal of diagnosing and removing HPV for a prolonged or indefinite length of time, as well as to protect the patient from any malignant ransformation, does not currently exist. The identification of HPV strains by PCR or DNA hybridization in lesional tissue provides higher security for the patients. In high-risk patients additional colposcopy, rectoscopy, and rethroscopy/cystoscopy increase the probability of proper diagnosis and the application of a reliable therapeutic strategy. Removal of lesions by means of invasive methods, such as electrodessication, cryosurgery, and/or laser therapy, may be successful and could be combined pre- and postoperatively with the local application of podophyllotoxin, Trichloroacetic acid, 5-fluorouracil epinephrine gel, imiquimod, cidofovir or interferon. The administration of vaccine to young patients prevents to a significant extent the clinical manifestation of the most frequent viral strains, being HPV-6,-11 and -18. The different therapeutic methods must be applied in accordance with the clinical picture, taking into account the patient's general status, the presence of concomitant diseases, as well as the local and systematic compatibility of the side effects of each remedy. The review focuses on the diagnosis and treatment options of sexually transmitted HPV-infections and includes synopsis of the most recent literature regarding new data of epidemiology, pathogenesis, ifferential diagnosis and morphology of HPV infections in humans.A família de papiloma vírus humano (HPV) compreende mais de 100 genótipos. Aproximadamente 30 dos genótipos são responsáveis pelas infecções na área anogenital em humanos. Não dispomos no momento de um algoritmo precisamente definido tendo como meta o diagnóstico e a remoção de HPV por períodos de tempo prolongados ou indefinidos, nem para proteção do paciente contra transformação maligna. A identificação das cepas de HPV por PCR ou hibridização de DNA em tecido lesional oferece maior segurança para os pacientes. Em pacientes de alto risco realiza-se ainda colposcopia, rectoscopia e uretroscopia/ cistoscopia, aumentando a probabilidade do diagnóstico correto e a aplicação de estratégia terapêutica confiável. A remoção das lesões por meio de métodos invasivos, como a eletrodissecção, criocirurgia, e/ou terapia com laser, pode ser bem sucedida e combinada no pré e no pós-operatório com a aplicação local de toxina podofílica, ácido tricloroacético, gel de epinefrina 5-fluorouracil, imiquimod, cidofovir ou interferon. A administração da vacina em pacientes jovens é capaz de previnir as manifestações clínicas das cepas virais mais frequentes, que são HPV-6, -11 e -18. Os diferentes métodos terapêuticos devem ser aplicados de acordo com o quadro clínico, levando em consideração o estado de saúde geral do paciente, a presença de doenças concomitantes, assim como a compatibilidade local e sistêmica dos efeitos adversos em cada remédio. A revisão foca o diagnóstico e as opções de tratamento de infecções por HPV sexualmente transmitidas e inclui uma sinopse da literatura mais recente no que diz respeito aos dados de epidemiologia, patogênese, diagnóstico diferencial e morfologia de infecções por HPV em humanos.