Condylomata Acuminata (see Colour Atlas D7) Human papillomavirus (HPV) Clinical presentation latent infection ...
Condylomata Acuminata (see Colour Atlas D7)
- Human papillomavirus (HPV)
Clinical presentation
- latent infection
- no visible lesions
- detected by DNA hybridization tests
- asymptomatic
- subclinical infection
- visible lesion only after 5% acetic acid applied and magnified
- clinical infection
- visible wartlike lesion without magnification
- hyperkeratotic, verrucous or flat, macular lesions vulvar edema
- lesions tend to get larger during pregnancy
- > 60 subtypes of which > 20 are genital subtypes
- classified according to risk of neoplasia and cancer
- types 16, 18, 45, 36 (and others) associated with increased incidence of cervical and vulvar intraepithelial hyperplasia and carcinoma
Diagnosis
- cytology (Pap smear)
- koilocytosis = nuclear enlargement and atypia with
perinuclear halo - biopsy of visible and acetowhite lesions at colposcopy
- detection of HPV DNA using nucleic acid probes not routinely done
Treatment (see Gynecological Oncology Section)
- chemical : trichloroacetic acid (podophyllin, 5-FU)
- physical: cautery, cryotherapy, laser
- condyloma should be treated early during pregnancy if not successful then C-section should be considered
- cannot be prevented by using condoms
Molluscum Contangiosum
- epithelial proliferation caused by a growth-stimulating poxvirus (Molluscipoxvirus)
- mildly contagious
Symptoms
- occasionally mild pruritis
Clinical presentation
- multiple nodules up to 1 cm diameter on vulva and
perineum with umbilicated center
Treatment
- chemical : carbonic acid, TCA, or silver nitrate
- physical : curette
