Condyloma acuminatum can be white, pink, or gray, and the surface may be vesicular, oozing, ulcerated, bleeding, or infected. Initially, the lesions are single, multiple, or clusters of small reddish granules with soft, slightly sharp tips, sometimes so small that they are indistinguishable to the naked eye. The lesions gradually increase in size and can be papillary, cauliflower, or coronal in shape. In men, they occur on the nipples, coronal sulcus, prepuce, urethra, penis, and perineum, and in women, they occur on the labia majora and minora, vaginal opening, clitoris, vagina, cervix, perineum, and perianal area. In homosexuals, it occurs in the anus and rectum. In a few patients, it can occur in areas other than the anogenital area, such as the mouth, armpits, breasts, and fingernails.