The signs and symptoms of condyloma acuminata include the following features:

• The warts are flesh colored and round in shape. They can take the shape of cauliflower or can appear flat.
• The warts usually do not cause any pain or discomfort; however they can bleed and even cause pain during sexual intercourse if they are located in the vaginal region.

• Pain

  The pain was moderate in both groups and peaked earlier in the analgesics group (median: 5 minutes) but later in the two-step irradiance group (median: 15 minutes). AFTER IRRADIATION: The pain was generally mild. [ncbi.nlm.nih.gov]

  While warts are often asymptomatic, at other times they can cause pain, itching, burning, irritation against clothing, and occasionally bleeding. 4 They can also cause pain and bleeding during sexual activity. [cfp.ca]

  VIN, PIN and PAIN in young women and men: Under the age of 40, most women with VIN, men with PIN and both sexes with PAIN have HPV as the cause. [web.archive.org]

• Fever

  False: Cold sores and fever blisters are not herpes. True: Cold sores and fever blisters on or around the mouth are caused by the herpes simplex virus—usually HSV-1. This is called oral herpes. [thehelpernewsletter.org]

  The side effects of fever, chills, myalgia, headache, fatigue, and leukopenia occurred more commonly in the interferon group than in the placebo group, but such effects rarely disrupted daily routines. [nejm.org]

  Interferon injections (an antiviral drug) which often produces fever, chills, and headaches. Prescriptive medicines for use at home that may also be used include: Podofilox gel or solution which stops the growth of the wart cells. [web.archive.org]

  For men and women who have had laser surgery, call your doctor if you have any of the following: Bleeding that lasts longer than 1 week A fever Severe pain Bad-smelling or yellowish discharge, which may point to an infection Avoid sexual intercourse until [northshore.org]

• Swelling

  Risks Laser surgery may cause any of the following: Pain, swelling, or itching Discharge from the vagina or penis Sores in the area treated Tissue that sticks together Shedding of dead tissue Scarring Urination that occurs in a wide, spraying stream, [northshore.org]

  In appearance, genital warts are often flesh-colored or gray swellings. If several cluster together, they may resemble a cauliflower. Some may be too small to be seen by the naked eye. [medicalnewstoday.com]

  In men, 5- fluorouracil applied bid to tid is highly effective for urethral lesions, but rarely, it causes swelling, leading to urethral obstruction. [merckmanuals.com]

  The surgery may cause a swelling, pain, redness, or even a scar. The options available include: Cryotherapy: Liquid nitrogen is used to freeze the wart tissue and form a blister on the skin. [dovemed.com]

• Surgical Procedure

  The patient with BLT must be very carefully clinical and imagistic investigated in order to detect the tumor visceral invasion and to establish the extension of the surgical procedure. [ncbi.nlm.nih.gov]

  Treatment The treatment of genital warts consists on their destruction, which can be done through surgical procedures, by chemical cauterization of the lesions (use of caustic substances) or cryosurgery (destruction of lesions with liquid nitrogen). [dermatologyforyou.com]

  In addition, in case of multiple warts surgical procedures may be required. Also, cryotherapy can be conducted for freezing the warts. [symptoma.com]

• Disability

  Please enable JS and disable any ad blocker [obgyn.net]

• Papule

  We report a case of a perianal EMPD with multiple verrucous papules on its surface. [ncbi.nlm.nih.gov]

  As these areas are essentially warm, moist and subjected to friction, the papules soon become eroded and sodden but still show the characteristic induration at the base so typical of an early syphilitic papule. [stdpioneer.org]

  Clinical presentation: The appearance ranges from a 5mm papule to large fleshy tumour mass involving anogenital region. Microscopic features: Hyperkeratosis, acanthosis, papillomatosis together with superficial koilocytosis and hypergranulosis. [histopathology-india.net]

• Pruritus

  She was brought to our clinic with pruritus, painful urination and four discharge and treated with electrocautery. Histological examination revealed acanthosis, nuclear basophilic inclusions and vacuolar degeneration. [ncbi.nlm.nih.gov]

  These lesions are generally not painful, but they can be associated with pruritus. Bleeding can be observed if the lesions become confluent and are irritated by clothing. [dermpathdiagnostics.com]

  The chief complaint usually is one of painless bumps, pruritus, or discharge. Involvement of more than 1 area is common. History of multiple lesions, rather than 1 isolated wart, is common. [emedicine.medscape.com]

  crural folds Clinical features Flat, dome shaped, keratotic, pedunculated or cauliflower shaped Singly or in clusters White, skin colored, pink, purple, red or brown ( Dermatol Online J 2006;12:5 ) Most are asymptomatic but may exhibit symptoms of pruritus [pathologyoutlines.com]

• Erythema

  Adverse Effects of Treatment The side effects of each treatment method and the risk of recurrence are summarized in Table 3. 8 – 13 All of these treatment methods can cause considerable discomfort, erythema, epithelial erosion, ulceration at the treatment [aafp.org]

  […] treatment Localized burning, pain, itching, erosion, inflammation Limit < 2 cm 2 of skin surface No; is teratogenic Sinecatechins (green tea extract) 15% ointment 17, 18 (grade B, level II; 2 trials) ‡ 57 6.5 Apply 3 times/d for up to 16 wk Localized erythema [ncbi.nlm.nih.gov]

  Eruptions' color may be the same as the skin, or they may exhibit erythema or hyperpigmentation. Check for irregularity in shape, form, or color suggestive of melanoma or malignancy. [emedicine.medscape.com]

  Erythema is often seen as a side effect with imiquimod therapy and sometimes appears to precede clinical resolution. Occasionally, severe inflammation is seen necessitating discontinuation of therapy. [hindawi.com]

• Dermatitis

  In this case, transmission of the human papilloma virus might have occurred during close, non-sexual contact with the infected mother, and the depressed immune response associated with atopic dermatitis appears to have played an important role in the [ncbi.nlm.nih.gov]

  Dermat. 82 : 95, 1960. Google Scholar 5. Moriame, G.: Transformation maligne de végétations vénériennes de la verge. Arch. belges dermat. et syph. 6 : 175, 1950. Google Scholar 6. [springerlink.com]

  Mycoses (Chromoblatomycosis or verrucous dermatitis):- In this condition, prominent papillomatous vegetations are chiefly confined to the feet and the legs. [stdpioneer.org]

  Contact Dermatitis 1983 ; 9 : 95 –8. View Abstract Request Permissions If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. [sti.bmj.com]

• Skin Rash

  Skin rash and sore throat then develop. If left to progress, syphilis can cause serious conditions such as stroke, paralysis, blindness or death. [bbc.co.uk]

  Condyloma latum:- It may manifest in generalised syphilis at the muco-cutaneous junctions, at times, even prior to the appearance of the skin rash. [stdpioneer.org]

• Suggestibility

  RESULTS: The resected specimens of six men infected with human immunodeficiency virus showed features suggestive of HSIL, including the expansion of basaloid cells, severe nuclear pleomorphism in the lower one-third, bizarre nuclei, mitotic figure in [ncbi.nlm.nih.gov]

  […] evidence to suggest they are effective or safe. [en.wikipedia.org]

• Genital Lesions

  Danya Reich, Corinna Eleni Psomadakis and Bobby Buka, Genital Lesions: Molluscum Contagiosum and Warts, Top 50 Dermatology Case Studies for Primary Care, 10.1007/978-3-319-18627-6_32, (199-209), (2016). [doi.org]

  Gissman L, Schneider A: Human papillomavirus DNA in preneoplastic and neoplastic genital lesions. In R Peto, H zur Hansen (Eds): Banbury Report 21. New York: Cold Spring Harbor, 1986, pp. 217–224. Google Scholar 4. [link.springer.com]

  The presence of lesions on the genitalia can cause severe stress in some individuals The genital warts usually do not become cancerous. [dovemed.com]

• Cesarean Section

  As this is a rare, non-malignant condition, and it is unclear whether the newborn becomes infected during birth or post partum, cesarean section is not recommended for prevention (grade C, level II). 4 There is a consensus of expert opinion that attempts [cfp.ca]

  Whether cesarean section prevents respiratory papillomatosis in infants and children also is unclear ( 781 ) ; therefore, cesarean delivery should not be performed solely to prevent transmission of HPV infection to the newborn. [cdc.gov]

  Cesarean section is not absolutely indicated. Few documented cases of HPV transmission to infant at time of delivery have resulted in laryngeal papillomas, a rare and life-threatening condition. HPV vaccination is contraindicated in pregnancy. [tipsdiscover.com]

  Additionally, no controlled studies have suggested that cesarean section prevents this condition. The one clinical indication for c-section that involves HPV is the presence of extensive vaginal and/or introital warts blocking the birth canal. [web.archive.org]

Diagnosis of condyloma acuminata begins with a past medical history of the disease and sexual life of the affected individuals. Following this, the following diagnostic procedures are carried out:

• Tests for sexually transmitted diseases.
• Pap smear test to detect acanthosis, nuclear abnormality, koilocytic abnormality and papillomatosis. 
• Filter hybridization is also required for analyzing the genotype of HPV involved.
• Biopsy of the warts is required to confirm the diagnosis if the warts harden and appear to be darker than the skin color.

• Human Papillomavirus

  In situ hybridization of the paraffin-embedded material revealed infection with human papillomavirus types 6/11. [ncbi.nlm.nih.gov]

  papillomavirus infection ( A63.0 ) viral warts due to human papillomavirus infection ( B07 ) ICD-10-CM Diagnosis Code B34 Viral infection of unspecified site 2016 2017 2018 2019 Non-Billable/Non-Specific Code Type 1 Excludes anogenital human papillomavirus [icd10data.com]

It is difficult to cure condyloma acuminatum. The treatment regimes are geared towards effective resolution of the warts and prevent the spread of the viral infection to rest of the body. The following are the various methods employed for treating condyloma acuminatum:

• Application of imiquimod cream [4] and podofilox gel to the affected area daily for a period of 8 weeks. These work by boosting the immune system to ward off the virus from the body. The medicated creams should be avoided by pregnant women and couples should not wear the cream during sexual activity [4].
• Cyrotherapy is often the treatment of choice when the warts have enlarged and do not respond to medications. It is the method of freezing warts by use of liquid nitrogen [5].
• Surgery is required when there are multiple warts causing great discomfort to the patient [6].
• Laser treatment is employed when there are several warts in the urethra or vaginal region. This carbon dioxide photodynamic option reserves the least recurrence rate for condyloma acuminatum [7].
• Ultrasound guided harmonic scalpel may be used to remove anorectal lesions [8].

Several treatment cycles would be required for resolving the warts. However, if the warts do not respond to 6 consecutive treatment cycles then the patients are usually given other treatment regime.

Condyloma acuminatum cannot be cured. However, with appropriate treatment the conditions can be managed in about 60 to 90% of cases. Warts may reappear after specific periods, but cannot turn cancerous in nature if managed well with treatment. Failure to initiate appropriate treatment regime can pave way for secondary complications.

Complications

Individuals suffering from condyloma acuminate when fail to receive medical attention are at risk of developing anogenital cancer [2]. Patients pose a potential risk of suffering from esophageal, lung and bladder cancer. Also, there are high chances of developing cancer of the vagina, vulva, anus and penis [3].

Infections by HPV are the major causative factor. Two genotypes 6 and 11 are known to trigger majority of the cases of condyloma acuminatum. In addition, genotypes 16 and 18 are also considered to be high risk because these are known to cause cervical and anal cancer. These genotypes however have minimal association with genital warts. The factors that increase the risk of contracting HPV include:

• Being sexually active with multiple partners
• Practicing sex without any protection
• Smoking
• Delivery through an infected vaginal canal [1]

In the United States, the prevalence of condyloma acuminatum has been reported to be more than 50%. Teenagers and young adults are more susceptible to develop genital warts; with the rate of incidence been highest for individuals aged 20 to 24 years. It has also been estimated that women are more prone to contract genital warts than males.

The human papillomavirus causes condyloma acuminatum. The virus enters the human system by invading the basal cells of the epidermis. After gaining entry the virus causes development of mucosal microabrasions. Individuals can live with no signs and symptoms for several weeks to months. After the latent phase, the formation of warts takes place. The most commonly affected regions include the vagina, cervix, penis, perianal area, vulva and perineum.

Condyloma acuminatum can be prevented by practicing safe sex or abstaining from sexual activity. It is also advised that men or women have only one sexual partner and that they refrain from having sex with multiple partners. HPV cannot be prevented by using condoms during sexual intercourse.

Vaccine known as Gardasil has been introduced that protects against 4 strains of HPV infections [9]. Therefore, about 90% cases of condyloma acuminatum can be prevented with this vaccination.

Condyloma acuminatum, commonly referred to as genital warts is one of the most common forms of sexually transmitted diseases. It is caused by human papillomavirus (HPV) affecting millions of individuals across the globe. There are over 100 strains of HPV and subtypes 6 and 11 are known to trigger majority of the cases of condyloma acuminatum. Individuals who are sexually active with multiple partners fall easy prey to HPV infections.

Definition

Condyloma acuminatum is a disease characterized by development of warts in the genital region. It is one of the most common types of sexually transmitted diseases and should receive prompt diagnosis and treatment to avoid onset of cancer. It is caused due to human papillomavirus (HPV) that has more than 100 strains. Of these, 2 genotypes 6 and 11 are known to cause the majority of genital warts. It has been estimated that about 75 – 80% of sexually active men and women can fall prey to condyloma acuminatum.

Cause

Infection by HPV is the major cause of condyloma acuminatum. The infections spread by skin to skin contact with an infected person. Factors such as having multiple partners and smoking also increase the risk of contracting genital warts.

Symptoms

Usually genital warts are present with no symptoms. These are round shaped and flesh colored. However, they can sometimes cause discomfort, pain and bleed during intercourse.

Diagnosis

Visual examination of the warts followed by biopsy would help in achieving an appropriate diagnosis. In addition, laboratory tests to identify the strain of HPV involved and Pap smear test would also be carried out.

Treatment

Condyloma acuminatum cannot be cured. The warts can be resolved and the spread of infection avoided with proper and rigorous treatment regime. Application of topical agents on the warts along with various therapies forms the basis of treatment regime. In addition, in case of multiple warts surgical procedures may be required. Also, cryotherapy can be conducted for freezing the warts.

1. Sinal SH, Woods CR. Human papillomavirus infections of the genital and respiratory tracts in young children. Semin Pediatr Infect Dis. Oct 2005; 16(4):306-16.
2. Nordenvall C, Chang ET, Adami HO, Ye W. Cancer risk among patients with condylomata acuminata. Int J Cancer. 2006; 119(4):888-93 (ISSN: 0020-7136)
3. Kishimoto T, Mabuchi S, Kato H, Kimura T. Condyloma acuminata induces focal intense FDG uptake mimicking vaginal stump recurrence from uterine cervical cancer: a case report. Eur J Gynaecol Oncol. 2013; 34(1):99-100 (ISSN: 0392-2936)
4. Haidopoulos D, Diakomanolis E, Rodolakis A, Vlachos G, Elsheikh A, Michalas S. Safety and efficacy of locally applied imiquimod cream 5% for the treatment of condylomata acuminata of the vulva. Arch Gynecol Obstet. 2004; 270(4):240-3 (ISSN: 0932-0067)
5. Tzathas C, Stavrianeas NG, Triantafyllou K, Triantafyllou G, Ladas SD. Long-term follow-up of endoscopic therapy of anal canal condylomata acuminata with podophyllotoxin. J Eur Acad Dermatol Venereol. 2007; 21(3):364-7 (ISSN: 0926-9959)
6. Zimmerman EE, Crawford P. Cutaneous cryosurgery. Am Fam Physician. Dec 15 2012; 86(12):1118-24.
7. Safi F, Bekdache O, Al-Salam S, Alashari M, Mazen T, El-Salhat H. Management of peri-anal giant condyloma acuminatum--a case report and literature review. Asian J Surg. Jan 2013; 36(1):43-52.
8. Zhu X, Chen H, Cai L, Yu Z, Cai L. Decrease recurrence rate of condylomata acuminata by photodynamic therapy combined with CO2 laser in mainland China: a meta-analysis. Dermatology. 2012; 225(4):364-70.
9. Colombo-Benkmann M, Tübergen D, Buchweitz O, Senninger N. Ultrasonic technology: a new treatment option for anal condylomata acuminata.Dis Colon Rectum. 2008; 51(11):1681-5 (ISSN: 1530-0358)
10. FDA News Release - Oct 16, 2009. FDA Approves New Indication for Gardasil to Prevent Genital Warts in Men and Boys. Accessed November 30, 2009.