Anal dysplasia
What is anal dysplasia?
The official medical term is squamous intraepithelial dysplasia. Simply put, they are tiny lesions on the skin of the anus.
When these lesions are mild then we call the condition low-grade dysplasia (low-risk dysplasia).
If the lesions are more extensive, then we call it high-grade dysplasia (High-risk dysplasia).
Infection of the skin of the anus requires infection with the HPV virus, also known as the wart virus.
High-grade dysplasia (the most aggressive form) is considered a precursor to anal cancer. According to the available data, low-grade dysplasia (milder form) does not lead directly to anal cancer.
However, the presence of low-grade dysplasia raises the suspicion that somewhere else in the anus there is a "hidden" source of high-grade dysplasia.
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Anal malformations are due to HPV infection, but HPV infection in the anus does not always lead to dysplasia.
Symptoms
Anal malformations are most often asymptomatic. This makes it difficult to diagnose early, and therefore to treat them.
We must emphasize that the earlier the diagnosis is made, the easier, probably, their treatment will be.
If the patient has previously been diagnosed with an HPV infection (eg warts), a visit to the doctor is necessary to complete the diagnosis and treatment of anal malformations.
Photos of anal dysplasia
Diagnosis of anal dysplasia
Proctoscopy is needed to correctly diagnose anal dysplasia.
This is an easy and quick way for the doctor to detect lesions on the skin of the anus.
The use of special dyes identifies suspicious areas from which biopsies are obtained. It is a short procedure and is performed under local anesthesia.
Treatment
CO2 Laser Cauterization
The treatment for anal malformations is performed with cauterization, where they are eliminated and their development stops.
Finally, a specialist doctor will perform all the necessary actions in order to identify and treat the accompanying lesions, and of course will prescribe the necessary medication after cauterization.
Anal Dysplasia - Risk Factors
Factors that increase the risk of anal dysplasia may be:
- Warts in the perinatal and / or perianal area
- Men who have sex with men
- HIV infection
- Women diagnosed with cervical dysplasia
- Intravenous drug use
- Smoking
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Frequently Asked Questions
Is there a method of diagnosis other than proctoscopy?
Yes. The test can be done in a similar way with the Pap smear. That is, by using a swab to collect a sample for microscopic examination. It is done without proctoscopy. This way is simple, fast and painless. Unfortunately, it has serious drawbacks. It is a blind process (we do not see from where we take the sample) and therefore the negative result can not rule out the existence of dysplasia. Also in case of a positive result, an additional proctoscopy should be performed.
Does low-grade anal dysplasia need treatment?
The only indications for treatment of low-grade dysplasia are symptoms such as itching or burning in the area. Treatments are not contraindicated in case one wishes for a feeling of greater security to carry out treatment.
How often should it be re-checked?
The time period is not the same for everyone but in general the re-check is performed once every 6 months. Regular re-examination is extremely important as dysplasia can recur long after treatment.
What is the risk of developing cancer?
The exact percentage is not known, but the risk is clearly higher for people who are HIV positive. In high-grade dysplasia it has been estimated that the average time from the diagnosis of dysplasia to the onset of cancer is 5 years.