I. Cutting-edge academic review Condyloma acuminatum is caused by human papillomavirus (HPV), HPV is the smallest DNA virus, resistant to drying and can be preserved for a long time. More than 100 subtypes have been detected and 34 of them have been found to be related to condyloma acuminatum. 15 of the most predominant condyloma-associated subtypes, including 6, 11, 16, 18, 30, 31, 32, 42, 43, 44 51, 52, 53, 54, 55, and most commonly 6, 11, 16, 18. The human body is the only natural host for HPV, which can only multiply in human surviving tissue cells and cannot grow in tissue culture or cell culture in vitro, nor can it be inoculated for growth in experimental animals. The immune mechanism of condyloma acuminatum has not been elucidated, and it is currently believed that defects in cellular immunity play an important role in the recurrence of condyloma acuminatum. This is because warts tend to grow rapidly and have a high recurrence rate in pregnant women, so it is also thought that estrogen plays an important role in the development of warts. The clinical manifestations of condyloma acuminatum are diverse, including classic, flat, papular and keratinized. The classic type is associated with HPV6 and 11, which are often burr-like or cauliflower-like, the flat type is dominated by HPV16 and 18, and the keratinized type is associated with HPV6. Condyloma acuminatum is more common in men in the coronal sulcus, glans, foreskin, tether, urethra, anus and scrotum, and in women in the labia majora and minora, hymen However, in men, perianal warts are not sexually transmitted, but rather are contracted by HPV inoculation due to localized skin disease. The most common method to identify warts is the white acetate test, but it is sensitive to hyperplastic tissue and has a high false-positive and false-negative rate. There has been some progress in the development of HPV vaccines, including VLP vaccines and DNA vaccines, which have been shown to stimulate specific humoral and cellular immunity to the body, potentially becoming a new way to prevent and treat condyloma acuminata. Second, clinical issues 1, atypical condyloma acuminata what, how to diagnose? The atypical condyloma acuminata are mainly flat, papular and keratinized, flat as a macular rash or raised skin surface in the form of macules, often linear arrangement; papular type for domed papules, can be fused; keratinized surface rough, sometimes similar to common warts. The actual fact is that you can find a lot of people who are not able to get a good deal on a lot of things. 2, why female condyloma acuminata in pregnancy will recur frequently and growth accelerated? The first is due to changes in the immune balance of women during pregnancy, cellular immunity to humoral immunity during pregnancy, cellular immune function decline, and cellular immune deficiency plays an important role in the recurrence of condyloma acuminata; second, there are studies that the rise in estrogen levels during pregnancy is an important factor in the recurrence of condyloma acuminata, but because there is not much research, and the immune mechanism of condyloma acuminata is not well studied, so The actual type of treatment for condyloma acuminata is what? If the number of warts is small, the volume is small, you can use drug therapy; if the number or volume is large to consider in the exfoliation of the premise of laser and other physical therapy; for flat type condyloma cryotherapy and external immunomodulatory drugs better results; urethra, anal canal, vaginal warts recommended physical therapy plus external immunomodulatory drugs treatment; for frequent recurrence can consider the system using immunomodulatory drugs, to enhance the cellular immune function. 4, how to deal with warts during pregnancy? The use of drugs or a large area of laser treatment, the production can choose cesarean section to avoid fetal infection. 5, the treatment of anal canal warts? The first thing you need to do is to rule out the possibility of HIV infection. If you are infected with HIV, you have to treat it on the basis of anti-viral and immune enhancement to get results. The combination of photodynamic therapy and surgical excision of larger warts is possible. The exposure of the anal canal is particularly important, and two-point anal sphincter anesthesia can be performed to expose the anal canal as much as possible.