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Now, let’s go over some physiology. The outermost layer of the skin is called the epidermis, and it has multiple cell layers that are composed of developing epithelial cells. The innermost layer, called the basal layer, contains basal cells, which continually move up in the epidermis and divide and replicate to form new cells that replenish it. As these cells move up, they mature, become flatter, and lose their ability to replicate. Ultimately, when the cells reach the top layer, they are shed from the epithelium, so that a new generation of cells can come in and take their place.
Now, genital warts occur due to infection of the basal cells caused by human papillomavirus, or HPV for short, which is one of the most common sexually transmitted infections, or STIs. HPV is a large family of DNA viruses with over 100 strains; specifically, genital warts are most commonly caused by HPV strains 6 and 11, which are considered to be low-risk because they typically cause benign growths. On the other hand, high-risk HPV strains 16 and 18 have a high risk of causing malignant growths, including cancer of the cervix, anus, and penis, as well as cancer of the upper respiratory tract.
Now, HPV infection is typically spread through direct skin-to-skin contact with an infected client, and there is a higher risk in clients who engage in unprotected sex or who have multiple sexual partners. Additional risk factors include early age at first sexual intercourse, smoking, or having a compromised immune system. Finally, pregnant clients are at risk of transmitting HPV to their baby during labor.
Normally the basal cells are well protected underneath all the other epidermal layers. However, if there are micro-abrasions or cuts in the epidermis, HPV can gain access to the basal cells and infect them. Once that happens, HPV replicates by causing the infected cells to divide uncontrollably, thus forming these benign skin growths called warts.
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