What is the pathophysiology of condyloma acuminatum?

Updated: Oct 22, 2018
  • Author: Delaram Ghadishah, MD; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

Cells of the basal layer of the epidermis are invaded by human papillomavirus (HPV). These penetrate through skin and cause mucosal microabrasions. A latent viral phase begins with no signs or symptoms and can last from a month to several years. Following latency, production of viral DNA, capsids, and particles begins. Host cells become infected and develop the morphologic atypical koilocytosis of condyloma acuminatum.

The most commonly affected areas are the penis, vulva, vagina, cervix, perineum, and perianal area. 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.

Consider sexual abuse as a possible underlying problem in pediatric patients; [2] however, keep in mind that infection by direct manual contact or indirectly by fomites rarely may occur. Finally, passage through an infected vaginal canal at birth may cause respiratory lesions in infants. [2]


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