0521779407-C03 CUNY1086/Karliner 0 521 77940 7 June 4, 2007 20:54
388 Condyloma AcuminataCondyloma Acuminata................................
DAVID OUTLAND, MD and JEFFREY P. CALLEN, MD
REVISED BY JEFFREY P. CALLEN, MD
history & physical
■Usually asymptomatic but can be pruritic or painful
■Sexually transmitted in adults, but may not always be sexually trans-
mitted in children
■The most common STD in the United States
■Caused by human papillomavirus infection
■Most common HPV types are 6 and 11
■Can also be caused by types 16, 18, 31, and 33
■Types 16, 18, 31, and 33 can cause intraepithelial neoplasia that may
eventuate into squamous cell carcinoma
■Flesh colored verrucous papules most commonly on the shaft, glans,
or corona of the penis in men, or on the vulva or adjacent skin in
women
■May also occur on the scrotum, perineum, pubis, groin and anus
tests
■5% acetic acid application may highlight subclinical or small lesions
■Biopsy is diagnostic, but is rarely necessary
differential diagnosis
■Condyloma lata
■Bowenoid papulosis
■Molluscum contagiosum
■Lichen planus
■Pearly penile papules
■Nevi
■Skin tags
■Squamous cell carcinoma
management
■Discuss with patient viral and infective nature.
■Discuss need for condom usage.
■Tell patient need for partner to be evaluated.
■Counsel and test patients for other sexually transmitted diseases.
■Most therapies are destructive.
specific therapy
■Destructive therapies
➣Liquid nitrogen cryotherapy