Genital warts are a very common STI.
Caused by human papillomavirus (HPV) infection, most commonly HPV types 6 and 11.
Peak incidence of genital HPV infection occurs in 16- to 25-year-olds.
Diagnosis is made based on clinical presentation.
Generally has a benign course and is not often associated with oncogenic potential.
Treatment can be challenging, as there is no cure and recurrences are common.
Genital warts are the most prevalent form of viral genital mucosal lesions and are caused by infection with several types of human papillomavirus (HPV). The infection manifests as verrucous fleshy papules that may coalesce into plaques. Lesion size ranges from a few millimetres to several centimetres. The warts may be located anywhere in the anogenital or genital area, including on mucosal surfaces. The colour can vary from whitish to flesh-coloured to hyperpigmented to erythematous. Lesions typically appear within weeks to months after exposure to HPV. They are generally asymptomatic, but may be painful, friable, or pruritic. This topic will cover diagnosis and treatment of internal and external warts, excluding cervical warts.
History and exam
Key diagnostic factors
- increased risk of exposure to HPV
- sessile exophytic papillomas
Other diagnostic factors
- urinary symptoms
- intercourse at an early age
- increasing number of lifetime sexual partners
- young sexually active adults
- increasing number of partner's lifetime sexual partners
1st investigations to order
- no initial test
Investigations to consider
non-pregnant and immunocompetent
Natalia Mendoza, MD
Pariser Dermatology Specialist
NM declares that she has no competing interests.
Stephen K. Tyring, MD, PhD, MBA
Departments of Dermatology, Microbiology and Molecular Genetics and Internal Medicine
University of Texas Health Science Center
SKT declares that he has no competing interests.
Dr Natalia Mendoza and Dr Stephen K. Tyring would like to gratefully acknowledge Dr Brenda L. Pellicane, a previous contributor to this topic.
BLP declares that she has no competing interests.
Angela Moore, MD
Clinical Assistant Professor
University of Texas Medical Branch at Galveston
AM declares that she has no competing interests.
Steve Baguley, FRCP, MSc
Consultant Genitourinary Physician
SB declares that he has no competing interests.
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