Genital Wart

Genital warts (also known as condylomata accuminata) are a common cause of attendance at genitourinary clinics. They are caused by the many varieties of the human papillomavirus HPV, especially types 6 & 11. It is now well established that HPV (primarily types 16,18 & 33) predisposes to cervical cancer.

Features

• small (2 - 5 mm) fleshy protuberances which are slightly pigmented
• may bleed or itch

Management

• topical podophyllum or cryotherapy are commonly used as first-line treatments depending on the location and type of lesion
  • multiple, non-keratinised warts are generally best treated with topical agents
  • solitary, keratinised warts respond better to cryotherapy
• imiquimod is a topical cream that is generally used second line
• genital warts are often resistant to treatment and recurrence is common although the majority of anogenital infections with HPV clear without intervention within 1-2 years