STDs WITHOUT ULCERS

CONDYLOMA ACUMINATUM

Condyloma acuminatum is caused by the human papilloma virus (HPV). It is
the most common overall STD in women, as well as the most common viral
STD. Transmission can occur with subclinical lesions. HPV subtypes 16 and 18
are associated with cervical and vulvar carcinoma, whereas condyloma is
associated with HPV types 6 and 11. Predisposing factors include
immunosuppression, diabetes, and pregnancy.

HPV is subclinical in most infected women. Symptoms of pain, odor, or
bleeding occur only when lesions become large or infected. Clinical lesions are
found in only 30% of infected women.

The characteristic appearance of a condyloma is a pedunculated, soft papule
that progresses into a cauliflower-like mass. The most common site of lesions
is the cervix.

Diagnosis. The lesions have an appearance so characteristic that biopsy is
seldom necessary.

Management. Topical or local. Systemic therapy is not available.

Patient-applied topical treatment:  podofilox   [Condylox]  solution    or  gel

(antimitotic    drug),  imiquimod   [Aldara]    cream   (topically  active  immune-

enhancer),  or  sinecatechins   ointment    (green-tea  extract)