A lesion is any abnormality in the tissue of an organism, usually caused by disease or trauma. Anal lesions are often abnormalities that can be seen on the surface of the skin of the anus. However, anal dysplasia is a pre-cancerous condition in which lesions have formed in or near the anal canal. These lesions are skin cells that have changed into abnormal cells. They are often caused by human papillomavirus (HPV), which is also the cause of anal warts. Anal dysplasia is not cancer, but the lesions can turn into cancerous tumors. That is why regular screening is so important.
Some people have a higher risk of getting anal dysplasia due to:
- Human papillomavirus (HPV) infection in the genital or anal area
- Abnormal pap test
- Medications that weaken the immune system
Other mitigating factors include having multiple sex partners or anal sex without a condom, smoking cigarettes, or being 40 or older.
Often there are no obvious symptoms, or symptoms do not appear until anal dysplasia has advanced to anal cancer. Symptoms, when they do appear, include:
- Pain or pressure
- Feeling a lump near the anus
- Discharge of pus or mucus
- Changes in bowel habits
An anal Pap test is done to screen for anal dysplasia. A cotton swab is used to collect cells which are sent to a lab to check for abnormalities. If the Pap test finds abnormal cells, a high-resolution anoscopy (HRA) is used to look into the anal canal. Our specialists will collect tissue for a biopsy and treat any discovered lesions or anal warts.
Treatment may involve electrocautery (EC) which is a small device that heats and destroys surface cells of the lesion or wart. Recovery is brief, but the treatment may need to be done multiple times depending on the number of lesions. Sometimes, we treat with a topical cream that is applied for 5 days, followed by a break for 9 days, repeating 4 times.