Genital wart in Adult
Transmission of HPV infection can occur through either direct contact, autoinoculation, or fomite transfer. The average incubation period for warts ranges from 2-3 months but can extend to 1 year. Most lesions are symptomless; however, associated symptoms can include itching, bleeding, and dyspareunia.
The highest risk population for HPV infection is sexually active women younger than 26 years. However, HPV infection can affect patients of any sex and a wide span of ages from infants to the elderly.
During pregnancy, condyloma acuminata can demonstrate rapid growth. The presence of condyloma acuminata has been associated with higher cesarean delivery rates. There is a small risk of transmission to the infant, with studies estimating the risk of maternal-child transmission with development of disease in the child to be 1 in 1500.
In immunosuppressed patients, warts proliferate due to suppressed cellular immunity and carry a risk of carcinogenesis. An increased prevalence of anogenital warts is noted in this population. Recurrences are common and response to treatment is impaired.
Related topic: oral mucosal wart
A63.0 – Anogenital (venereal) warts
240542006 – Condyloma acuminatum
Differential Diagnosis & Pitfalls
- Pearly penile papules – Appear in parallel rows on the corona glandis or frenulum of the penis.
- Lichen planus
- Lichen nitidus
- Molluscum contagiosum – Shiny papules 2-5 mm in diameter with central umbilication.
- Seborrheic keratoses
- Melanocytic nevi
- Fordyce spots – Sebaceous glands.
- Nodules of scabies
- Epidermal nevus
- Condyloma lata (secondary syphilis) – Lesions tend to be flatter and smoother than condyloma acuminata.
- Vestibular papillae (also known as vulvar papillomatosis, a normal variant of female external genitalia) – Softer than condyloma, and symmetrically or linearly distributed compared to irregular distribution of condyloma; base of individual lesions remains separate compared to coalescing of superficial projections seen in condyloma.
- Herpes simplex virus (HSV) – Particularly in immunocompromised individuals.