The diagnosis points (1) contact history: a history of direct contact, spousal infection or indirect contact. Most male patients will admit to a history of extramarital sexual contact; female patients usually express innocence, and most of their male partners examined do have no visible redundancy on their external genitalia, and some may be positive if HPVDNA testing is done. The latest CDC guidelines for the treatment of condyloma acuminatum, published on June 5, 2015, state that HPV infection usually occurs concurrently between sexual partners, but it is not possible to determine who was first infected with HPV. the fact that a person is infected with HPV does not mean that the person himself/herself or his/her sexual partner had sex with him/her. (2) Clinical manifestations: 1. Multiple pink, grayish-white or grayish-brown redundant organisms around the external genitalia, perineum or anus (occasionally in the oral cavity, breasts, etc.), which may be flat, papillate, corkscrew or cauliflower-shaped; 2. Generally no conscious symptoms, some patients have itching, foreign body sensation, pressure or pain. Often bleeding due to increased brittleness. Women may have increased leucorrhea. The sudden appearance of multiple papules with rough or soft surfaces and no obvious conscious symptoms on the originally smooth vulvar skin mucosa should be considered. In men, the most common sites are the coronal groove, prepuce, glans, inner foreskin, urethra, penile body, perianal area, scrotum, groin, and pubic bone area. In females, the labia majora and minora, vaginal opening, vaginal wall, clitoris, cervix, urethra, perineum, and perianal area in that order, and occasionally outside the genital area. The majority of the warts are well diagnosed by combining the site of onset and the morphology of the lesions. If necessary, the skin lesion biopsy tissue is tested with antigen or nucleic acid to show HPV infection. 3. Positive white acetate test. Histopathology is an important basis, and the other two can be used for reference. 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. The actual fact is that you can’t get a definite diagnosis or you can do it at the request of the patient. 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. But this is for reference only, because HPV infection is common, some asymptomatic sexually active people in the external genitalia, urethra, cervical can be detected HPV infection, most of them are transient, can be automatically cleared by the body’s immunity, this is not necessary to make a fuss. Also a negative result does not rule out HPV infection, as the infected HPV subtype may be outside the reagents used for the test. The vinegar white test is not a specific test and false positive results can occur for some chronic inflammation, non-specific inflammation or epithelium that is first healed after trauma, in addition, sometimes the tissue is dense and the possibility of false negatives exists. Therefore, our 2014 edition of the guidelines for the treatment of acromegaly did not mention the white acetate test in relation to laboratory tests. (4) Case classification: Reported cases are clinical diagnosis cases, in view of the fact that some patients will deny the history of exposure or really can’t say, our 2014 version of the condyloma acuminatum diagnosis guidelines to the clinical diagnosis of cases of diagnostic criteria should be consistent with the clinical manifestations, with or without epidemiological history. This means that a clinical diagnosis of acromegaly can be made on the basis of typical clinical manifestations. This is no surprise, in the big family of viral warts, common warts, plantar warts, flat warts are diagnosed by clinical performance, the diagnosis of condyloma acuminata is not more difficult. The following differential diagnosis is still from the “Advanced Course in Dermatologic Venereology” edited by Professor Zhang Xuejun in 2010, which is a more complete summary. The pseudo warts are seen as multiple, clustered granular papules or vaginal vestibules symmetrically distributed on the inner labia minora or vaginal vestibule in females; pathological examination is free of vacuolated cells; white acetate test is negative. Pseudovaginal warts are very common, with a smooth, moist, soft surface and uniform size, like fish-egg or villous projections, and are well identified. The actual fact is that the woman’s inner labia and vestibule are often white after using 5% acetic acid, which shows a uniform and consistent patchy white spot, which is the false positive of acetic acid white. (2) Penile pearly papules: small conical or filiform, single or multiple rows of white or reddish papules on the edge of the male coronal sulcus, 1-3mm in diameter, not fused, no conscious symptoms; negative white acetate test. (3) flat warts: the characteristic lesions of stage II syphilis; mainly in the anogenital area in clusters of maroon patches with a wide base and no tip, a flat surface, vesicles, may have dense particles, papillary, cauliflower-shaped; dark field microscopy can be found syphilis spirochetes; syphilis seropositive. The flat warts are often accompanied by other manifestations of second-stage syphilis, such as red papules on the palms of the hands and feet, and worm-like alopecia, which can help identify them. In addition, syphilis serologic tests occasionally have negative results, should be considered before the band phenomenon or HIV infection. (4) Bowen-like papulopathy: easily occurs in young men and women with multiple pigmented papules on the genital skin mucosa, which may fuse into plaques and may fade on their own; histopathology resembles Bowen-like changes. They are often multiple, flattened, and more uniform in shape. (Pathological examination is necessary to suspect the disease.) (5) Genital squamous cell carcinoma: clinically similar to giant CA; mostly seen in older patients, with obvious infiltration of skin lesions, hard texture, easy bleeding, and often forming ulcers; characteristic changes of squamous cell carcinoma can be seen in histopathology. (6) Ectopic sebaceous glands: occurring on the inner side of the lips, glans and labia, they are several or dozens of hemispherical papules, 3-125px in diameter, with skin color or yellowish color, which may be accompanied by pruritus and rarely fade on their own. Histopathological examination can confirm the diagnosis. (7) Genital area sweat duct tumor: It is usually found on the inner part of the labia majora in women, and consists of several or dozens of hemispherical papules, 3-5 mm in diameter, with skin color or yellowish color, which may be accompanied by pruritus and rarely resolves on its own. Histopathological examination can confirm the diagnosis. (8) Glossy moss: mostly in children and young people, mostly on the penis, glans, lower abdomen, inner femoral flanks, etc., manifesting as uniform shiny or round flat-topped papules, pinpoint to corn size, dense but not fused, without self-conscious symptoms; pathologically characterized by hugging globular inflammatory infiltrates, with diagnostic significance. (9) Infectious molluscum contagiosum of the pubic area: it occurs around the genital area, the lesions are initially hemispherical papules of rice grain to soybean size, slightly concave in the center in the form of umbilical fossa, the surface is waxy and shiny, containing white cheese-like material, the cortex emanates, and does not fuse. The above diagnostic points and differential diagnosis can diagnose the majority of condyloma acuminata, and the rest, such as penile sclerosing lymphangitis, angiokeratoma, and scabies nodules, can also be noted to exclude. The actual fact is that you can find a number of atypical ones clinically, which will require further examination.