Diagnosis

Condyloma acuminatum

Etiology

Cause [7e4]

• HPV infection

Pathophysiology [7e4]

1. Primarily spread through sexual contact

2. Infection of squamous epithelial cells --> virus can remain in a latent

3. HPV contains an oncogene --> proteins that stimulate cell proliferation

4. The number of infected squamous epithelial cells grows --> the epidermis thicken --> acanthosis/warts

Risk factors [7e4]

• Age

• Number of lifetime sexual partner

• History of chlamydia and gonorrhea infections

• Smoking

• HIV

Complications [7e4]

• Some HPV subtypes (16 and 18) can cause malignancy (anal/cervical/vaginal/oropharyngeal)

• Warts may recur after treatment because of activation of latent virus present in healthy skin adjacent to the lesion

Epidemiology

Incidence per 100.000 [rv2][du2]

Approach

• Cytology (Pap test)

• PCR

• Acetic Acid Test

• Biopsy

Treatment

1. Prophylaxis --> Vaccine [uao]

2. Non-surgical treatment options:

   • Cytotoxic / antiproliferative drugs: podofilox, podophyllin, 5-FU, salicylic acid, trichloroacetic acid, and bichloracetic acid

   • Immune response modifiers (imiquimod and interferon alfa)

   • Sinecatechins ointment

   • Trichloroacetic acid solution

   • Isotretinoin

3. Surgical eradication or reduction of symptoms [rio]

   • Surgical excision

   • Chemical ablation

   • Cryotherapy (Liquid nitrogen)

   • Laser surgery

   • Electrocauterization

   • Photodynamic therapy

4. Squamous intraepithelial dysplastic lesions

   • Elimination --> Surgical excision

Differential diagnoses

Acquired digital fibrokeratoma, Acrochordon, Actinic keratosis, Anal cancer, Arsenical keratosis, Basal cell carcinoma, Cervical cancer, Cutaneous horn, Fibroepithelial polyp, Hemorrhoids, Herpes simplex, Hidradenitis suppurativa, Keloid, Keratoacanthoma, Lichen nitidus, Lichen planus, Molluscum contagiosum, Neurofibromatosis, Nevus, Penile cancer, Pityriasis versicolor, Prurigo nodularis, Psoriasis, Rectal cancer, Seborrheic keratosis, Squamous cell carcinoma, Syphilis