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Human Papilloma Virus and Genital Warts

HPV is the most common tumor of the vulva. The incubation period varies from weeks to months.

Clinical evaluation

Condyloma acuminata lesions appear as rough, verrucous papillomas on the genitalia. Enlargement often occurs during pregnancy.

No practical screening tests for subclinical infection exist. Pap smear diagnosis of HPV does not correlate well with detection of HPV DNA.

Treatment of genital/perianal warts

Cryosurgery with liquid nitrogen or cryoprobe is more effective than

Podophyllin 25% in of benzoin may be applied and washed off 4 hours later. Two or 3 applications, 1 week apart, may be needed. Podophyllin should not be used on the vagina or cervix; it is contraindicated in pregnancy.

Podofilox 0.5% ( Condylox) solution for self-treatment: Apply twice daily for 3 days followed by 4 days of no therapy.

Surgical excision and electrocoagulation or laser may be

Large, bulky or extensive lesions

General anesthesia and wire loop cautery is effective.

Topical 5-fluorouracil cream in a 1-2% concentration is effective in the treatment of vaginal condylomata.

Recurrence rates are high (25% within 3 months). No therapy has been proven to eradicate HPV.

Partner referral

Examination

Annual Pap smears are recommended for partners.

The use of condoms

 

 

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