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Return to: Twitter Facebook Linkedin Reddit Get Citation Citation AMA Citation Condylomata Acuminata. In: Doherty GM. Doherty G.M. Ed. Gerard M. Doherty.eds. Quick Answers Surgery New York, NY: McGraw-Hill; 2010. http://accesssurgery.mhmedical.com/content.aspx?bookid=853§ionid=49662054. Accessed May 22, 2017. MLA Citation . "Condylomata Acuminata." Quick Answers Surgery Doherty GM. Doherty G.M. Ed. Gerard M. Doherty. New York, NY: McGraw-Hill, 2010, http://accesssurgery.mhmedical.com/content.aspx?bookid=853§ionid=49662054. Download citation file: RIS (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager © Copyright Tools Search Book Top Return Clip Condylomata Acuminata + Essential Features Print Section + • Human papillomavirus (HPV) causes condylomata acuminata• Multiple types have been identified-Types HPV-6 and HPV-11 are associated with the common benign genital wart-HPV-16 and HPV-18 are associated with the development of high-grade anal dysplasia and anal cancer• Most common sexually transmitted viral disease ++ Epidemiology + • 1 million new cases reported per year in the United States• Most common anorectal infection of homosexual men and is particularly prevalent in HIV-positive patients• Disease is not limited to men or women who practice anoreceptive intercourse• In women, the virus may track down from the vagina, and in men it may pool and track from the base of the scrotum• Immunosuppression, either from drugs after transplantation or from HIV, increases susceptibility to condylomatous disease with prevalence rates of 5% and 85%, respectively + Clinical Findings Print Section ++ Symptoms and Signs + • Complaint is a perianal growth• Pruritus, discharge, bleeding, odor, and anal pain common complaints• Classic cauliflower-like lesion, which may be isolated, clustered, or coalescent• Warts tend to run in radial rows out from the anus + Diagnostic Considerations Print Section + • Condylomata lata lesions of secondary syphilis• Anal squamous cell carcinoma ++ Rule Out + • Malignancy + Work-up Print Section + • History and physical exam• Anoscopy and proctosigmoidoscopy are essential because the disease extends internally in more than 75% of patients• HPV-16 and HPV-18 are causally associated with squamous cell carcinomas of the anal canal-Representative biopsies of clinically apparent condylomas should be sent for pathologic study because unsuspected low-grade or high-grade dysplasia or squamous cell carcinoma of the anal canal may be found + Treatment and Management Print Section + • Extent of the disease and the risk of malignancy determine the treatment• Minimal disease is treated in the office with topical agents• Warts respond promptly to therapy• More extensive disease may require an initial treatment session under anesthesia so that random lesions can be excised for pathologic evaluation to rule out dysplasia and the remainder coagulated• Laser therapy is another method of condyloma destruction ++ Surgery ++ Indications + • Extensive disease may require an initial treatment session under anesthesia so that random lesions can be excised for pathologic evaluation to rule out dysplasia ++ Medications + • Topical agents: Bichloracetic acid or 25% podophyllum resin in tincture of benzoin ++ Treatment Monitoring + • Patients should be seen at regular intervals until resolution is complete• Follow-up evaluation may reveal residual disease, but this is often easily treated with topical agents in the office ++ Complications + • Squamous cell carcinoma of the anal canal is the major complication ++ Prognosis + • Laser fulguration: Recurrence rates are low• Disease may respond to excision or destruction followed by intralesional interferon or autogenous vaccine created from excisional biopsies of the lesions + Resources Print Section ++ References ++Chang GJ, Welton ML: Human papillomavirus, condylomata acuminata, and anal neoplasia. Clin Colon Rectal Surg 2004;17:55. ++Centers for Disease Control and Prevention: Sexually transmitted diseases treatment guidelines 2002. MMWR 2002;51. ++Hakim AA et al: Indications and efficacy of the human papillomavirus vaccine. Curr Treat Options Oncol 2007;6:393.