Condylomata acuminata

Last Updated: 2021-10-15

Author(s): Anzengruber F., Navarini A.

ICD11: -

Genital warts, pointed condylomas, moist warts, anogenital warts.

Highly infectious sexually transmitted disease (STD).

Most frequently transmitted viral STD worldwide.

About 1% of the population (15-49 years of age) suffers from condylomata acuminata.

It is assumed that the probability of developing condylomata acuminata up to the age of 27 can be estimated at 4.7%.

HPV prevalence in women in the pre-vaccination era is estimated at 9-21%.

Due to HPV vaccines, the incidence of anogenital warts has already decreased in 15-19 year old women (data from Australia partly speak of a decrease of almost 90% in sick women!)

No gender difference. Highest prevalence in young adults up to 40 years of age.

Predisposing factors: Immunosuppression, nicotine abuse, promiscuity.

LR-HPVs, especially type 6 and 11, are considered to be the cause for more than 90% of all anogenital condylomata acuminata.

Incubation period from weeks to 6 months.

Spontaneous remission in up to 30%.

Condylomas can occur both genital and anal.

Painless, often confluent, skin-colored-livid, soft, partly exophytically growing papules, plaques and tumors.

Clinic

Biopsy, if necessary.

An acetic acid test for 5 minutes (5% external, 3% vaginal and intraanal) shows a white coloration. This traditional test is not always specific.

If necessary, proctoscopic examination (MSM).

If the urethra entrance is affected, no cystoscopy without prior remediation (contamination).

Determine hepatitis B, C, syphilis and HIV serology in each patient!

Discreet hyperkeratosis, focal parakeratosis, pronounced acanthosis, enlarged reteleists, coilocytes, no enlargement of the stratum granulosum (distinguishing feature from verruca vulgaris).

Frequent recurrences. Inform patients about this from the beginning!

Both girls and boys should be vaccinated with a tetravalent vaccine (types 6, 11, 16, 18) from the age of 9 but before the first sexual intercourse. If this has already been done, an individual decision must be made.

Follow-up checks to exclude a recurrence after approx. 6 months, earlier in case of recurrence if necessary.

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