Which physical findings are characteristic 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

Single or multiple papular eruptions may be observed. Eruptions may appear pearly, filiform, fungating, cauliflower, or plaquelike. They can be quite smooth (particularly on penile shaft), verrucous, or lobulated. Eruptions may seem harmless or may have a disturbing appearance.

Carefully search for simultaneously involved multiple sites.

Eruptions' color may be the same as the skin, or they may exhibit erythema or hyperpigmentation. Check for irregularity in shape, form, or color suggestive of melanoma or malignancy.

Propensity has been established for penile glans and shaft in men and for vulvovaginal and cervical areas in women. In contrast to early reports, presence of external condyloma acuminatum in both men and women warrants a thorough search for cervical or urethral lesions. Such internal lesions have been found in more than one half of females with external lesions. One report indicates that infected males have a 20% chance of having subclinical urethral lesions. 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.

Urethral meatus and mucosal lesions can occur. Some are subclinical. Hair or the inner aspect of uncircumcised foreskin hides some lesions.

Search for evidence of other STDs (eg, ulcerations, adenopathy, vesicles, discharge).

Look for perianal lesions, particularly in patients with history or risk of immunosuppression or anal intercourse.


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