Condyloma Acuminatum - Causes, Symptoms and Treatment

Condyloma acuminata are Papillomavirus-induced soft, pink growths that appear singly or in clusters in moist areas around the genitalia and rectum. More than 100 types of double-stranded HPV papovavirus have been isolated to date. Many of these have been related directly to an increased neoplastic risk in men and women. This disease is one of the most common STDs in the United States. Approximately 90% of condyloma acuminata are related to HPV types 6 and 11. These 2 types are the least likely to have a neoplastic potential. Risk for neoplastic conversion has been determined to be moderate or high , with many other isolated types. The picture is complicated by proven coexistence of many of these types in the same patient (10-15% of patients), the lack of adequate information on the oncogenic potential of many other types, and ongoing identification of additional HPV-related clinical pathology. Uncommon mucosal lesions in the oropharynx, larynx, and trachea have been reported. HPV-6 even has been reported in other uncommon areas (eg, extremities). Multiple simultaneous lesions are common and may involve subclinical states as well-differentiated anatomic sites. Subclinical infections have been established to carry both an infectious and oncogenic potential. During pregnancy, the prevalence of condyloma increases from the first to third trimester and decreases significantly in the postpartum period. The risk of condyloma acuminata in pregnancy is 2-fold. First, the lesions can become large enough to obstruct labor.

Condyloma large can cause tenesmus and may result in transmission to neonates during childbirth. Such neonatal transmission is thought to cause childhood laryngeal papillomatosis. HPV infection appears to be more common and worse in patients with various types of immunologic deficiencies. Recurrence rates, size, discomfort, and risk of oncologic progression are highest among those patients. Secondary infection is uncommon. Latent illness often becomes active during pregnancy. Vulvar condyloma acuminata may interfere with parturition. Trauma then may occur, producing crusting or erythema. Bleeding has been reported in large lesions that can occur during pregnancy. More than 50% of female patients with external lesions have been found to have negative Papanicolaou (Pap) tests but tested positive for HPV infection using in situ hybridization. Several of the epidermotropic HPVs cause condyloma acuminata. HPV types 6 and 11 most commonly are isolated, but many of the more than 60 types of HPV potentially cause condyloma. Male partners of women with cervical intraepithelial neoplasia often have infections with the same viral type. The presence of genital condyloma in the pediatric population presents a diagnostic and therapeutic challenge. Vertical transmission of HPV can occur via in utero exposure to amniotic fluid or transmission of HPV from the maternal genital tract. An incubation period of several months is usually required between virus infection at delivery and clinical manifestations in the infant.

Causes of Condyloma Acuminatum

Common Causes of Condyloma Acuminatum

• Papillomavirus (HPV).
• Cervical intraepithelial neoplasia.
• Poor personal hygiene
• Heavy perspiration.

Sign and Symptoms of Condyloma Acuminatum

Common Sign and Symptoms of Condyloma Acuminatum

• Bleeding.
• Pain.
• Odor.

Treatment for Condyloma Acuminatum

Common Treatment for Condyloma Acuminatum

• Condyloma Acuminatum treat until recently with applications of podophyllum resin , a corrosive substance that cannot be given to pregnant patients. A milder form of podophyllum, podofilox (Condylox), has been introduced.
• Women are also treated with 5-fluorouracil cream, bichloroacetic acid, or trichloroacetic acid. All of these substances irritate the skin and require weeks of treatment.
• Condyloma Acuminatum can also be treated with injections of interferon. Interferon works best in combination with podofilox applications.
• Use of condoms minimizes but does not eliminate the risk of HPV transmission.