Summary
Definição
As verrugas genitais são a forma mais prevalente de lesões virais da mucosa genital, sendo causadas pela infecção por vários tipos de papilomavírus humano (HPV).[1] A infecção se manifesta como pápulas carnudas e verrucosas que podem coalescer e formar placas. O tamanho das lesões varia de alguns milímetros a vários centímetros.[2] As verrugas podem localizar-se em qualquer parte da área genital ou anogenital, inclusive nas superfícies das mucosas.[3] A coloração varia de esbranquiçada à cor da pele, de hiperpigmentada a eritematosa.[Figure caption and citation for the preceding image starts]: Verruga na haste penianaDo acervo pessoal de Dr. Tyring; uso autorizado [Citation ends].
[Figure caption and citation for the preceding image starts]: Imagem ampliada de verruga penianaDo acervo pessoal de Dr. Tyring; uso autorizado [Citation ends].
As lesões geralmente aparecem algumas semanas ou meses após a exposição ao HPV.[4] As lesões são em geral assintomáticas, podendo ser dolorosas, friáveis ou pruriginosas.[5][6] Este tópico abrange o diagnóstico e o tratamento de verrugas internas e externas, exceto as verrugas no colo uterino.
História e exame físico
Principais fatores diagnósticos
- aumento do risco de exposição ao HPV
- imunocomprometimento
- papilomas exofíticos e sésseis
Outros fatores diagnósticos
- assintomático
- prurido
- sangramento
- dor
- sintomas urinários
Fatores de risco
- relação sexual em idade precoce
- número crescente de parceiros sexuais durante a vida
- adultos jovens sexualmente ativos
- número crescente de parceiros sexuais durante a vida do parceiro
- imunocomprometimento
Investigações diagnósticas
1st investigations to order
- nenhum exame inicial
Investigations to consider
- biópsia
- anuscopia
- uretroscopia
Treatment algorithm
pacientes não gestantes e imunocompetentes
imunocomprometido
gestante
Contributors
Authors
Natalia Mendoza, MD
Pariser Dermatology Specialist
Williamsburg
VA
Disclosures
NM declares that she has no competing interests.
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.
Disclosures
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.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
References
Key articles
Forcier M, Musacchio N. An overview of human papillomavirus infection for the dermatologist: disease, diagnosis, management, and prevention. Dermatol Ther. 2010 Sep-Oct;23(5):458-76. Abstract
Ahmed AM, Madkan V, Tyring SK. Human papillomaviruses and genital disease. Dermatol Clin. 2006 Apr;24(2):157-65. Abstract
Meites E, Szilagyi PG, Chesson HW, et al. Human papillomavirus vaccination for adults: updated recommendations of the Advisory Committee on Immunization Practices. MMWR Morb Mortal Wkly Rep. 2019 Aug 16;68(32):698-702.Full text Abstract
Beutner KR, Wiley DJ, Douglas JM, et al. Genital warts and their treatment. Clin Infect Dis. 1999 Jan;28 Suppl 1:S37-56. Abstract
Workowski KA, Bachmann LH, Chan PA, et al. Sexually transmitted infections treatment guidelines, 2021. MMWR Recomm Rep. 2021 Jul 23;70(4):1-187.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Diferenciales
- Condiloma lata
- Molusco contagioso
- Pápulas peroladas penianas
More DiferencialesGuías de práctica clínica
- Recommended adult immunization schedule for adults ages 19 years or older: United States, 2023
- Reducing sexually transmitted infections
More Guías de práctica clínicaFolletos para el paciente
Verrugas genitais
Vacina contra o HPV (papilomavírus humano)
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