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Genital wart - Anogenital in
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Genital wart - Anogenital in

See also in: Overview
Contributors: Priyanka Vedak MD, Susan Burgin MD
Other Resources UpToDate PubMed

Synopsis

Condyloma acuminata are warts that occur secondary to infection with the human papillomavirus (HPV), a double-stranded DNA that belongs to the family of Papillomaviridae. The incubation period from exposure to lesion development can last from months to years. High-risk and low-risk genotypes of HPV have been identified based on their prevalence in intraepithelial neoplasia and carcinomas. High-risk genotypes include types 16, 18, 31, 33, and 35, and low-risk genotypes include types 6 and 11.

Transmission of HPV infection can occur through either direct contact, autoinoculation, or fomite transfer. The average incubation period for warts ranges from 2-3 months but can extend up to 1 year. Most lesions are symptomless; however, associated symptoms can include itching, bleeding, and dyspareunia.

The highest risk population for HPV infection is sexually active women younger than 26 years. However, HPV infection can affect patients of any sex and a wide span of ages from infants to the elderly.

During pregnancy, condyloma acuminata can demonstrate rapid growth. The presence of condyloma acuminata has been associated with higher cesarean delivery rates. There is a small risk of transmission to the infant, with studies estimating the risk of maternal-child transmission with development of the disease in the child to be 1 in 1500.

In immunosuppressed patients, warts are thought to proliferate due to suppressed cellular immunity and have a risk of developing cancer. An increased prevalence of anogenital warts is noted in this population. Recurrences are common and response to treatment is impaired.

Related topic: oral mucosal wart

Codes

ICD10CM:
A63.0 – Anogenital (venereal) warts

SNOMEDCT:
240542006 – Condyloma acuminatum

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

There are many verrucous-looking lesions of the genitals:
  • Acrochordon
  • Lichen planus
  • Lichen nitidus
  • Molluscum contagiosum – Shiny papules 2-5 mm in diameter with central umbilication.
  • Seborrheic keratosis
  • Melanocytic nevi
  • Fordyce spots – Sebaceous glands.
  • Psoriasis
  • Nodules of Scabies
  • Keratinocytic epidermal nevus
  • Condyloma lata (Secondary syphilis) – Lesions tend to be flatter and smoother than condyloma acuminata.
  • Vestibular papillomatosis (also known as vulvar papillomatosis, a normal variant of female external genitalia) – Softer than condyloma, and symmetrically or linearly distributed compared to irregular distribution of condyloma; base of individual lesions remains separate compared to coalescing of superficial projections seen in condyloma.
  • Genital herpes simplex virus (HSV) – Particularly in immunocompromised individuals.
  • Papular acantholytic dermatosis
The giant condyloma or Buschke-Lowenstein tumor is a slow-growing, cauliflower-like tumor that is locally aggressive and destructive. It can demonstrate malignant transformation.

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References

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Last Reviewed:09/23/2021
Last Updated:10/15/2023
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Genital wart - Anogenital in
See also in: Overview
A medical illustration showing key findings of Genital wart : Verrucous scaly papule, Verrucous scaly plaque
Clinical image of Genital wart - imageId=77116. Click to open in gallery.  caption: 'A flat, pedunculated, pink and gray verrucous plaque at the inguinal fold.'
A flat, pedunculated, pink and gray verrucous plaque at the inguinal fold.
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