Condyloma acuminatum, also known as genital warts or venereal warts, is a common sexually transmitted disease caused by human papilloma virus (HPV) infection.
In men, these warts are papilla-like or cauliflower-like, red, moist and soft, and are found on the glans, coronal sulcus and tethered area.
In females, the lesions are usually found on the pubic area, vagina, and cervix, and are verrucous or cauliflower-like lesions, which may fuse with each other and appear as a bunch of grapes if the disease is prolonged.
[Pathogen]
Human papillomavirus, a DNA virus. The only hosts of HPV are the complex squamous epithelium of human skin and mucous membranes. There are more than 60 different subtypes of HPV, among which there are more than 10 subtypes that can cause condyloma, mainly types 6, 11, 16, 18 and 33.
[Transmission route].
It is mainly transmitted through sexual intercourse, but occasionally it can be transmitted through contact with HPV-contaminated objects such as bath tubs, towels and patients’ underwear.
[Clinical manifestations]
1, incubation period of 3 weeks to 8 months, the average is 3 months.
2, most often occurs in the male and female external genitalia and around the anus, with the male coronal groove, foreskin tie, female posterior union, the inner part of the labia majora and minora as the preferred sites, also seen in the vagina and cervix.
The initial damage is a small, soft, light red papule, which gradually grows and fuses with each other to form papilloma-like, cauliflower-like, cockscomb-like and straw-like redundant organisms, which may occasionally break down, exude and cause secondary infection.
4, generally no obvious conscious symptoms, such as secondary infection can be accompanied by pain, vaginal and cervical damage is manifested as increased leucorrhea or bleeding after sexual intercourse.
A few think about especially the huge condyloma acuminata can be secondary to cancer.
6, some cases are subclinical infection or HPV virus carriers, no visible clinical manifestations.
[Diagnostic points]
1, most have a history of impure sex or spousal infection, a few have a history of indirect contact with contaminants.
2, typical clinical manifestations.
3.White acetate test: Wrap gauze soaked with 3-5% glacial acetic acid solution on the suspected lesion for 3-5 minutes, if the affected area turns white, it indicates a subclinical infection.
4.Pathological examination helps in diagnosis, and the presence of vacuolated cells in the upper layer of trans-spinous cells is the most diagnostic.
5.Molecular biology techniques such as multiplex enzyme chain reaction (PCR) detect HPV, and this method can also be used as subtype determination.
[Differential diagnosis]
1, genital cancer: the lesions are hard, characterized by deep infiltration, easy to break down and complicate infection, if necessary, pathological examination must be done to determine the diagnosis.
2, flat warts: for the second phase of syphilis rash, mostly in the perianal and external genitalia around the flat descending, the surface moist, syphilis spirochete examination and serological tests can determine the diagnosis.
3, pearl Xiang penile papules: seen in adult men, for the edge of the coronal groove arranged along the rice grain size, domed, smooth papules, lesions of uniform size, do not fuse with each other, long-term unchanged.
[Treatment].
The best topical medication is Ketoma, which is less toxic, more thorough and leaves less scarring. In addition, individual patients need other treatment methods. The treatment is reviewed 3 months after cure to prevent recurrence.