Condyloma acuminata, or genital warts, are caused by HPV and are the most common sexually transmitted disease. They can occur in various locations and are diagnosed by their appearance. Treatments include topical agents, cryotherapy, and surgical excision. The HPV vaccine can prevent HPV-associated tumors and genital warts.
Condyloma acuminata, also known as genital warts or venereal warts, are skin lesions caused by the human papillomavirus (HPV). HPV is able to penetrate the skin through the micro-abrasions that result from sexual contact. Condyloma acuminata most commonly affect the penis, vagina, vulva, cervix, perianal area, and perineum. The oropharyngeal, laryngeal and tracheal regions may rarely be affected. Treatments include topical application of cytotoxic agents, cryotherapy, and surgical excision.
This disease is caused by various strains of HPV and is considered to be the most common of the sexually transmitted diseases. The most common strains implicated are HPV 6 and 11, but other subtypes can lead to the same manifestation. Condyloma acuminata can occur in clusters, either as tiny discrete lesions or large masses in the anogenital area. This explains why they are also called anogenital warts. When they are confined to the anal area, they are called anal warts.
In males, they frequently occur on the foreskin of the penis, while in females, they often occur on the vulva. Under microscopy, infected cells usually show koilocytosis, in which the nucleus becomes large and atypical. Another typical microscopic feature of cells is the formation of a cytoplasmic perinuclear halo or cytoplasmic vacuolization.
Despite the differences in location, the pathophysiology of condyloma acuminata is the same. Small lacerations or abrasions are made during sexual contact, providing a portal of entry for the human papillomavirus. The virus then infects the basal cells of the epidermis. A latency occurs and an infected person may not experience any manifestations for months or years. When latency ends, active production of viral deoxyribonucleic acid (DNA) and other essential particles occurs, leading to warty lesions.
An affected person typically goes to the doctor due to the presence of painless bumps in the genital or perianal areas, itching, or discharge. There is no specific laboratory test for condyloma acuminata because the appearance of the warts is often enough to make a diagnosis. Testing for other viral illnesses or STDs, such as human immunodeficiency virus (HIV), syphilis, gonorrhea, and chlamydia, may be done. In women, a Pap test is recommended to look for cell abnormalities that can increase the risk of cervical cancer.
Once condyloma acuminata is diagnosed, treatments such as podophyllum resin, podofilox, trichloroacetic acid, and imiquimod may be offered. When the perianal area is involved, cryotherapy may be preferred. Of the treatment options, surgical excision of the warts offers the highest success rate and the lowest recurrence rate. The prevention of HPV-associated tumors and genital warts is possible through the administration of the HPV quadrivalent vaccine.
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