Condyloma

Condyloma

 

Definition  

A sexually transmitted viral disease, also known as genital or venereal warts, characterized by papillomatous lesions that most commonly develop on anogenital skin and mucosa

 

Medical History  

* Pediatric, Adolescent (>12-18 years)

* Sexually active

* Homosexual

* Anal penetration

* Bisexual

* Past medical history of Victim of child molestation

* Immunodeficiency disorder

* Verruca vulgaris

* Subclinical infection

* Smoking

 

Findings  

* Lesion of bladder

* Lower urinary tract infectious disease

* Oral wart

* Anal warts

* Dyspareunia

* Genital warts

* Hematochezia

* Hematuria

* Pruritus ani

* Pruritus of genital organs

* Tenesmus

* Urethral discharge

* Vaginal bleeding

* Vaginal discharge

 

Tests  

 

Suspected condyloma acuminatum  

* Excision biopsy of skin lesion: Biopsy may be needed if the diagnosis is uncertain, the presentation is atypical, the patient is immunocompromised, or response to therapy is poor .

 

Differential Diagnosis  

* Condyloma latum

* Molluscum contagiosum infection - Acute

* Genital herpes simplex

* Skin tag

* Pearly penile papules

* Seborrhoeic keratosis

* Melanocytic nevus

* Bowenoid papulosis

* Granuloma inguinale

* Neoplasm of skin of perineum

 

Treatment  

 

Drug Therapy  

 

External genital warts of penis, vulva, scrotum, perineum, and perianal skin  

 

IMIQUIMOD  

Adults: Apply 5% cream topically to external genital warts once at bedtime 3 times a week for up to 16 weeks; wash treatment area with mild soap and water 6 to 10 hours after application

 

PODOFILOX  

Adults: Apply 0.5% solution or gel topically to external genital warts twice daily for 3 days; withhold for 4 days before reapplying; may repeat as necessary for a total of 4 cycles (maximum total wart area treated should be less than 10 cm2; maximum podofilox volume, 0.5 mL/day)

 

SINECATECHINS  

Adults: Apply a 0.5 cm strand of ointment topically 3 times daily to each external genital wart, ensuring complete coverage; continue treatment until complete clearance of warts, up to a maximum of 16 weeks

 

PODOPHYLLUM RESIN  

Adults: Apply 10% to 25% solution topically to each external genital wart in a thin layer and allow to air dry; wash off solution 1 to 4 hours after application; may repeat weekly if necessary (maximum total wart area treated should be less than 10 cm2/session; maximum podophyllum volume, 0.5 mL/session)

 

Trichloroacetic Acid  

Adults: Apply a small amount of 80% to 90% solution only to the warts and allow to dry, at which time a white frosting develops; if an excess amount of acid is applied, powder the treated area with talc, sodium bicarbonate, or liquid soap preparations to remove unreacted acid; may repeat weekly, if necessary

 

Genital warts on urethral meatus  

 

PODOPHYLLUM RESIN  

Adults: Apply 10% to 25% solution topically to each wart in a thin layer and allow to air dry; wash off solution 1 to 4 hours after application; may repeat weekly if necessary (maximum total wart area treated should be less than 10 cm2/session; maximum podophyllum volume, 0.5 mL/session)

 

Procedural Therapy  

 

Condyloma acuminatum  

* Cryotherapy of genital warts: Cryotherapy is a recommended treatment option for external genital warts, vaginal warts, urethral meatus warts, and anal warts .

 

Condylomata acuminatum  

* Excision of condylomata acuminatum: Surgical excision is one recommended treatment option for external genital warts and anal warts .