Erythroplakia of the cervix is a violation of the natural structure of the epithelium covering the cervix, characterized by tissue atrophy. Pathology is diagnosed quite rarely, which makes it impossible to study the disease in detail. That is why it is still considered little studied. Erythroplakia is a precancerous condition and occurs in women of all ages. Below we will talk in more detail about this disease and how to treat it.
Erythroplakia of the cervix - what is it?
This term refers to the pathology of the mucous tissues that are closer to the entrance to the vagina. The disease is characterized by atrophy of the superficial epithelial layer of the cervix. The disease is considered poorly understood, so information about it is incomplete and leaves many mysteries for professionals. Nevertheless, the disease is successfully treated and has a positive prognosis.
Erythroplakiacervix (ICD-10 code 87) got its name because of the peculiarities of the external manifestation. Translated from Greek, the name translates as "red spot". Pathology can develop both in women of childbearing age and in patients during menopause or postmenopause. The disease is easily diagnosed and is often accompanied by inflammatory processes (colpitis or cervicitis).
Erythroplakia (photo below) is a serious condition.
Since this condition is precancerous, it is timely diagnosis that is important. Proper treatment allows for a complete recovery of the patient and reduces the likelihood of malignant neoplasms.
Most often, erythroplakia of the cervix (ICD-10 87) is asymptomatic, but in some cases it may be accompanied by mucous secretions and contact bleeding. When making a diagnosis, the doctor takes into account the data of extended colposcopy, vaginal examination in the mirrors, histological examination of the biopsy, as well as cytological analysis. Most often, the treatment of the disease is carried out surgically using minimally invasive techniques, and the lesion of the cervical canal may be an indication for conization of the cervix.
Reasons
Erythroplakia of the cervix is an insufficiently studied and extremely rare disease, the causes of which are not completely clear. Experts identify several groups of women most susceptible to thispathology. Most often, the disease develops against the background of:
- Cervicitis (inflammation of the cervix).
- Infectious and inflammatory processes of various nature.
- Dysplasia.
- Various forms of colpitis.
In addition, disturbances in the structure of the epithelium can be triggered by injuries sustained during:
- damage to the cervix during childbirth;
- abortions;
- use of chemically aggressive methods of contraception;
- perform therapeutic or diagnostic curettage.
Also, experts believe that violations of the regenerative processes of damaged tissues, hormonal imbalance, endocrine disorders and malfunctions of the immune system contribute to the development of cervical erythroplakia.
Estrogen deficiency is especially dangerous. This is the reason for the violation of the proper formation of epithelial cells. Many doctors believe that erythroplakia can be transmitted genetically. Patients in whose genus the female line manifested such a disease, the risk of pathology is significantly increased.
Symptoms of cervical erythroplakia
Most often the disease is asymptomatic. Sometimes women notice slight bleeding that is not related to menstruation. This is due to the traumatization of the remote layer of the epithelial tissue. If the disease develops against the background of a local infection, then it will proceed with symptoms typical of inflammation. To theminclude:
- Discomfort.
- Pain in the vagina.
- Profuse serous-purulent discharge.
During a gynecological examination, bright red areas are clearly visible on the surface of the cervix. The spots stand out against the background of he althy integument, and has an uneven contour. Redness of the mucous tissue during erythroplakia occurs due to the thinning of the epithelium, due to which the blood vessels are translucent. Visually, the area of inflammation looks like a shiny spot that begins to bleed from any slightest injury (with tools or fingers).
Diagnosis
The protocol for cervical erythroplakia is not particularly difficult to diagnose. Confirm the disease and exclude oncology allow:
- Examination on the gynecological chair. On the surface of epithelial tissues, bright red or burgundy areas are visible, with clear boundaries and irregular shape. Touching the affected area may cause it to bleed.
- Extended colposcopy. The stroma of the cervix is visible through the thinned tissues. During the Schiller test (treatment of the epithelium with Lugol), the affected areas do not stain, and when 3% acetic acid is applied, they turn pale.
- Cytology of scrapings. This analysis reveals an increase in the number of basal cells with signs of atypia. If there are many atypical cells, the attending physician prescribes a targeted or conchotomy biopsy, as well as a study of the histology of cervical erythroplakia.
Ifthe disease is combined with infectious pathologies; a smear culture study, serological methods and PCR diagnostics are additionally used. To assess the general condition of the pelvic organs, an ultrasound scan may be prescribed. Erythroplakia can provoke cervical cancer, precancerous background conditions, endometriosis, leukoplakia, true erosion, cervicitis, adenomatosis, dysplasia. In difficult situations, an oncologist is involved in the diagnosis.
It is worth noting that most often the disease is detected after a standard examination on a chair. Additional tests are needed to rule out comorbidities, including cancer.
Treatment
Specialists consider two types of treatment for cervical erythroplakia: conservative and surgical, destroying pathological areas. Before choosing the appropriate therapy, the doctor considers the causes of the development of the disease and the current symptoms.
Treatment is possible with the following methods:
- By cauterizing the affected area with electric current.
- Treatment with liquid nitrogen.
- Treatment of cervical erythroplakia with hormones.
- Exposure to diseased areas with radio waves or a laser.
If necessary, conization of the cervix is performed. This type of therapy can be performed with a knife, laser or loop. The attending gynecologist selects the necessary therapy based on the results obtained during the diagnostic study.
Medicines
In most cases, gynecologists prescribe drug treatment to patients by taking immunostimulating and antiviral drugs, such as Panavir, Acyclovir, Immunal, Famvir, Polyoxidonium, interferons and other drugs. The duration of the course is determined by the doctor. If necessary, vaginal suppositories and creams are applied.
The main task during the treatment of erythroplakia is to relieve the existing inflammation. It is possible to start therapy aimed at treating the pathology itself only after the elimination of inflammatory processes. Cauterization by any methods is carried out only on conditionally he althy tissues, after which the patient is prescribed drugs with wound healing and antiseptic properties: suppositories "Galavit", "D-panthenol", "Suporon" and similar agents.
Hormones
In the event that the cause of erythroplakia is a hormonal failure, treatment is carried out by adjusting the background. Removal of the abnormal area is possible only after the normalization of the menstrual cycle. Most often, the following means are used for this:
- "Trisiston".
- "Utrozhestan".
- "Anteovin".
- "Lindinet" and others.
The appointment of hormonal drugs is made only after testing to determine the level of hormones in the blood.
Electric cauterization
This method is called diathermocoagulation. He is one ofthe oldest treatments. During the procedure, the affected area is exposed to high-frequency electric current. The duration of such treatment is about half an hour, the effectiveness is more than 70%, it may take from 2 to 4 months to fully recover after the procedure.
This type of treatment is accompanied by complications, including scarring on the cervix, which causes narrowing of the cervical canal. Electric cauterization is prescribed only for women who have given birth and who no longer plan to become pregnant.
Cryodestruction
This procedure involves exposure to atrophied areas with liquid nitrogen. In this case, the damaged areas are destroyed, and he althy tissues are simply frozen. The recovery period after cryodestruction takes from 8 to 12 weeks. This method is not used if the size of erythroplakia exceeds five millimeters. The advantage of liquid nitrogen therapy is the absence of scarring and soreness. After the procedure is completed, the patient can go home immediately and does not need hospitalization.
It is worth noting that if the doctor does not have enough practice, trauma to the walls of the vagina and the recurrence of erythroplakia are not ruled out. The cause of recurrence may be incomplete removal of atrophied areas.
Radio waves and laser
These procedures are painful, so anesthesia is necessary before the session. Laser treatment is carried out between the fifth and seventh days from the beginning of the last menstruation.
Forrestoration of damaged tissues will take a month and a half. During this period, a woman may experience pain in the lower abdomen and light bleeding. All this is considered acceptable. A complication may be the development of inflammation or infection of the treated area, but this can only be provoked by non-compliance with the recommendations of the gynecologist.
The radio wave method is used from the fourth to the ninth day from the beginning of the last menstruation, since it is at this time that bleeding is unlikely, and tissues recover much faster. The procedure takes no more than 15 minutes, and full recovery occurs in a month.
Consequences
The lack of timely treatment of erythroplakia of the cervix can lead to the transformation of the affected areas into malignant tumors. In this case, therapy may take much longer and may not always be successful.
It is worth knowing that erythroplakia is a precancerous condition and requires mandatory treatment. Since the disease is almost always asymptomatic, every woman is advised to have regular gynecological examinations.
Forecast and prevention
With timely detection and treatment of erythroplakia, the prognosis for recovery is favorable. Pathology becomes malignant very rarely, relapses after surgery are practically not observed. Patients are recommended cytological, colposcopic and bacteriological control 1 month after the therapeutic event, and then once every 3 months for 1 year. Also for the purposesprevention, it is necessary to be regularly examined by a gynecologist, treat inflammation of the reproductive system in a timely manner, refrain from unprotected sex and plan a pregnancy.
Reviews
Reviews of patients suffering from this disease most often speak of a successful cure. Since in each case the disease proceeds differently, due to the individual characteristics of any organism, the method of treatment and its duration can only be determined by a doctor.
