Parakeratosis of the cervix: what is it, signs, treatment, focal and superficial

What is cervical parakeratosis?

Doctors do not consider parakeratosis to be a separate disease. In their opinion, it is a sign of other various pathologies of the cervix. The disorder appears in conjunction with hyperkeratosis and acanthosis:

Hyperkeratosis is characterized by epithelial keratinization. When everything is normal with the cervix, its epithelium does not keratinize at all. Hyperkeratosis causes the formation of glycogen-deprived scales.
As for acanthosis, in addition to the same thickening of the epithelium, it is typically characterized by an increase in the length of the interpapillary processes.

Most often, this trio of pathologies is observed in patients with the dangerous precancerous disease leukoplakia.

Focal and superficial keratoses

In the absence of an invasive process, keratosis is called superficial, this is the least dangerous condition, however, it is subject to careful monitoring. Usually a small area of epithelium is involved in the process.

Focal parakeratosis of the squamous epithelium of the cervix is a dangerous phenomenon. With a focal process, the cell structure is changed, this is already a full-fledged symptom of leukoplakia (precancerous condition). The disease requires urgent treatment and elimination of the causes that led to the formation of white plaques on the surface of the cervix.

Cervical dysplasia is also characterized by the presence of altered epithelium. In the early stages of cancer, areas with a violation of the keratinization process - dyskeratosis - are diagnosed.

Causes

Parakeratosis can be caused by both internal (related to the physiological characteristics of the body) and external factors. The most common causes of the disease are:

chronic inflammatory processes caused by bacterial and viral pathogens that are transmitted during sexual intercourse. The main ones are chlamydia, mycoplasma, as well as viruses that cause the appearance of papillomas, the development of herpes and ureaplasmosis;
operations on the uterine cervix, childbirth and intensive medical procedures with elements of surgical intervention;
acute lack of zinc in the female body;
serious hormonal problems, especially those caused by high levels of estrogen and lack of progesterone;
pituitary dysfunction;
pathological lack of ovulation;
problems with immunity caused by the immunodeficiency virus (HIV), chronic diseases of the hematopoietic organs (primarily the liver), clinical depression and “unsparing” starvation diets;
repeated artificial termination of pregnancy (including in the early stages), frequent miscarriages;
uterine curettage (curettage), which was carried out for diagnostic purposes (to take a sample for analysis);
violation of the rules of “vaginal” hygiene;
radical methods of getting rid of uterine erosions (through electropenetration, cauterization);
incorrectly installed or low-quality contraceptive device;
various types of displacement of internal organs (ectopia). Especially those with whom relapses often occur;
extreme sexual practices, such as fisting (stimulation of the vagina with a hand clenched in a fist), the use of overly large dildos for self-satisfaction, rough, very fast sex;
inflammation of the mucous membrane of the cervix (exo- and endocervicitis), as well as inflammatory processes in the vaginal mucosa (vaginitis).

In addition, parakeratosis can be caused by severe emotional overload, chemotherapy and poor ecology.

Symptoms

In the initial stages, it is not easy to identify parakeratosis, since it does not cause any special symptoms. That is why it is extremely important for preventive purposes to visit a gynecologist at least once a year. Only he will be able to visually determine changes in the epithelium on the cervix and establish through examinations and tests whether this is a separate pathology or a sign of a more serious disease compared to parakeratosis.

Often parakeratosis is poorly visible against the background of pronounced manifestations of the disease that caused it. This happens especially often with infectious diseases, which are usually accompanied by pain or fever. These symptoms “muffle” the signs of parakeratosis. However, the pathology may be more noticeable. In such a case, parakeratosis is characterized by the following symptoms:

discharge of blood after sexual intercourse during the non-menstrual period. As a rule, it stands out a little;
unpleasant painful sensations during coitus;
increased (slightly) amount of vaginal secretion. At the same time, its smell is unpleasant, or at least not the same as always.

Thus, even signs of pronounced parakeratosis are not always noticeable. Only special diagnostics can identify them.

Complications

Parakeratosis is not an independent disease; it is often a manifestation of leukoplakia or chronic diseases of the cervix. With timely treatment and following the doctor’s recommendations, the pathology may disappear on its own.

Important . Advanced leukoplakia and untreated chronic diseases, together with HPV infection, will continue to affect abnormal cell division processes. The worst outcome may be cervical cancer.

Diagnostics

To make a correct diagnosis, the gynecologist must know about all the operations the patient has undergone, illnesses, the frequency and nature of her sexual contacts, and her lifestyle.

Full screening includes 4 mandatory procedures:

Oncocytology.
Liquid cytology.
Colposcopy.
Histological examination.

Parakeratosis is very similar to pseudoparakeratosis - severe cell atrophy, which often ends in the appearance of neoplasms. Therefore, in order to make sure that the cervix is affected by parakeratosis, it is important to undergo all 4 screening procedures.

Liquid cytology

Using a cytological examination, cells taken from the mucous membrane of the cervix are checked for the presence of pathologies. The liquid research method includes the following steps:

A sample of cells taken from the cervical mucosa is placed on a special membrane.
Then several special manipulations are performed with them to create a smear for analysis - staining, dispersion, and mixing. In this case, a special stabilizing solution is used.
Next, a microscopic analysis is carried out for the presence of pathologies.

Liquid-based cytology is considered a fairly accurate way to identify problems at the cellular level.

Oncocytology

Using oncocytology of the uterine cervix, it is determined whether the patient has cancer cells or benign neoplasms. The research technique is in many ways similar to conventional cytology (including liquid cytology).

Colposcopy

Using the colposcopic method, a specialist determines the exact location and size of the diseased area. A colposcope allows you to detect even microscopic pathological changes in the cervical mucosa.

Histology

Histological analysis, like oncocytology, is primarily aimed at identifying degenerated cells.

Signs

Depending on the degree of damage to mucous tissues, there are:

superficial parakeratosis, affecting only the upper layer of epithelial tissue in a small area;
focal parakeratosis, accompanied by damage to several large areas and deep layers of the epithelium, which is fraught with the development of neoplasms.

The pathology is asymptomatic for a long time, which hinders diagnosis in the early stages. In addition to unpleasant sensations during sexual intercourse, the clinical picture includes:

increased volume and change in odor of vaginal discharge;
aching uterine pain;
bleeding due to microtrauma after sexual intercourse;
burning and itching sensations in the genital area.

Treatment

Treatment of parakeratosis has two goals:

Getting rid of himself. To cure the disease, you will have to take antimicrobial anti-inflammatory drugs. It is not recommended to treat parakeratosis with various “folk” remedies (baths, tampons, syringes). Such therapy is ineffective and sometimes even harmful.
Elimination of all foci of the disease. Methods for their elimination may vary. It all depends on whether the patient has signs of an incipient malignant or benign tumor. Standard methods for eliminating areas with parakeratosis are:

vaporization (evaporation) using a laser;
diathermocoagulation (cauterization with electric current);
destruction by cold (cryodestruction using liquid ultra-cold nitrogen);
argon plasma coagulation (using argon gas plasma);
invasive intervention. It includes amputation, as well as conization (removal of a cone-shaped area). Invasive intervention is used only if focal parakeratosis begins to develop into precancerous leukoplakia, a neoplasm or cicatricial deformity appears.

It is not necessary to eliminate lesions if there are no traces of an incipient neoplasm, and the areas affected by the disease occupy a small area. In this case, simple treatment of parakeratosis with pharmaceuticals will suffice.

What do you need to remember?

Cervical parakeratosis is a process of keratinization of the epithelium.
The causes are chronic infection, HPV and hormonal imbalance.
The most unfavorable prognosis is for the focal type of parakeratosis.
The manifestations of parakeratosis are not specific; sometimes it occurs without giving a single symptom.
The choice of treatment method depends on the depth of the lesion and pregnancy planning.
The presence of complications is difficult to predict, but the most serious of them is degeneration into cancer.

Used Books

Diseases of the cervix. M.: GEOTAR-Media, 2014. 160 p.
Diseases of the cervix. Modern methods of diagnosis and treatment. M.: Publishing house of the Nizhny Novgorod State Medical Academy, 2006. 112 p.
Khachaturyan, A. R. Colposcopy. Fundamentals of diagnostic algorithms and tactics for managing cervical diseases. Methodical recommendations / A.R. Khachaturyan, L.V. Maryutina. M.: N-L, 2011. 523 p.
Prilepskaya V.N., Fokina T.A. Background diseases of the cervix: pathogenesis, diagnosis, treatment // Obstetrics. and gin. 1990. No. 6. P. 12-15.
Kulakov V.I., Prilepskaya V.N. Prevention of cervical cancer: a guide for doctors. M.: MEDpress-inform, 2008. 56 p.

Preventive measures

Woman:

Those who have overcome parakeratosis or who do not want to get it should take medications that contain zinc. In this case, she will not have to deal with this unpleasant pathology;
is at greater risk of developing parakeratosis than others if she has problems with the endocrine system or has had surgery on the uterine cervix. Such a lady should be especially picky about her sexual partners, since any sexually transmitted infection can lead to illness. Also, she should not randomly take the first hormonal drugs she comes across. This should only be done after consulting a doctor.

In order to avoid parakeratosis, you need to follow these simple rules:

Be sure to get vaccinated against papilloma virus (HPV infection).
Minimize unprotected sex with an “unverified” partner.
Do not forget about sexual hygiene - wash your intimate organs daily (best with herbal decoctions).
Swim in excessively hot water as little as possible.
Visit your gynecologist regularly.
Do not smoke and try not to passively inhale smoke.
Do not drink strong alcohol and do not eat fatty foods.
Do exercises, get enough sleep, don’t get nervous for no particular reason.

Diseases affecting the female reproductive system often seriously threaten reproductive function. Many of them are dangerous not only to the health, but also to the life of the patient. A woman’s biggest fear is the degeneration of pathology into a malignant formation. To avoid this, a woman simply must be constantly monitored by a specialist and not delay visiting a doctor if the slightest strange symptoms appear.

Disease prevention

Parakeratosis cannot be prevented by specific methods. Prevention can be reduced to the following points:

regular examination by a gynecologist, including cytological examination of smears, microflora analysis,
using appropriate contraceptive methods. The issue of taking hormonal medications should be discussed with your doctor.
protection against STDs and HPV,
timely treatment of inflammatory diseases,
a healthy lifestyle that minimizes overwork, stress, and poor nutrition.

The presence of parakeratosis is not a reason to panic; treatment measures should be carried out as planned. The most important point of prevention is medical supervision, since only a gynecologist can assess the degree of compliance with subsequent points and correct them.