Summary
Definition
Genital warts are the most prevalent form of viral genital mucosal lesions and are caused by infection with several types of human papillomavirus (HPV).[1] The infection manifests as verrucous fleshy papules that may coalesce into plaques. Lesion size ranges from a few millimeters to several centimeters.[2] The warts may be located anywhere in the anogenital or genital area, including on mucosal surfaces.[3] The color can vary from whitish to flesh-colored to hyperpigmented to erythematous. 
[Figure caption and citation for the preceding image starts]: Wart on shaft of penisFrom Dr Tyring's personal collection; used with permission [Citation ends].
[Figure caption and citation for the preceding image starts]: Close-up of penile wartFrom Dr Tyring's personal collection; used with permission [Citation ends]. Lesions typically appear within weeks to months after exposure to HPV.[4] They are generally asymptomatic, but may be painful, friable, or pruritic.[5][6] This monograph will cover diagnosis and treatment of internal and external warts, excluding cervical warts.
History and exam
Key diagnostic factors
- intercourse at an early age
- increasing number of lifetime sexual partners
- increasing number of partner's lifetime sexual partners
- immunocompromise
- female ages 19-22
- male ages 22-26
- sessile exophytic papillomas
Risk factors
- intercourse at an early age
- increasing number of lifetime sexual partners
- increasing number of partner's lifetime sexual partners
- immunocompromise
Diagnostic investigations
Treatment algorithm
Contributors
Authors
Natalia Mendoza, MD
Pariser Dermatology Specialist
Williamsburg
VA
Disclosures
NM declares that she is a board member of the Virginia Dermatology Society.
Stephen K. Tyring, MD, PhD, MBA
Clinical Professor
Departments of Dermatology, Microbiology and Molecular Genetics and Internal Medicine
University of Texas Health Science Center
Houston
TX
Disclosures
SKT declares that he has no competing interests.
Acknowledgements
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.
Peer reviewers
Angela Moore, MD
Clinical Assistant Professor
University of Texas Medical Branch at Galveston
Galveston
TX
Disclosures
AM declares that she has no competing interests.
Steve Baguley, FRCP, MSc
Consultant Genitourinary Physician
Woolmanhill Hospital
Aberdeen
Scotland
UK
Disclosures
SB declares that he has no competing interests.
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