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Genital Warts

A common sexually transmitted disease, genital warts are papillomas that consist of fibrous tissue overgrowth from the dermis and thickened epithelial coverings. Also known as venereal warts and condylomata acuminata, these growths are one of the most common sexually transmitted diseases in the United States.

Causes

More than 100 different types of HPV exist, most of which are harmless. About 30 types are spread through sexual contact and are classified as either low risk or high risk. Some types of HPV cause genital warts-single or multiple bumps that appear in the genital areas of men and women including the vagina, cervix, vulva, penis, and rectum. These are considered low risk types. High-risk types of HPV may cause abnormal Pap smear results and could lead to cancers of the cervix, vulva, vagina, anus, or penis. Many people infected with HPV have no symptoms.

Some types of HPV cause common skin warts, such as those found on the hands and soles of the feet. These types of HPV do not cause genital warts.

Symptoms and Signs

In many cases genital warts do not cause any symptoms, but they are sometimes associated with itching, burning, or tenderness. They may result in localized irritation, depending upon their anatomic location. Women who have genital warts inside the vagina may experience bleeding following sexual intercourse or an abnormal vaginal discharge. Rarely, bleeding or urinary obstruction may occur if the wart involves the urethral opening.

Diagnostic tests

Dark-field microscopy of wart-cell scrapings shows marked epidermal cell vascularization. This differentiates genital warts from condylomata lata associated with second-stage syphilis.

Another test involves applying 5% acetic acid (white vinegar) to the warts, which turn white if they are papillomas.

Treatment

Many cases of genital warts resolve spontaneously. Frequently used therapies include cryosurgery, application of caustic agents, electrodesiccation, surgical excision, and laser ablation. Topical anti metabolites, such as 5-fluorouracil, have also been used. Topical podophyllin agents may also be used. Topical interferon benefits condylomata acuminata. Vaccine preparations show promise in preventing papillomavirus.

Prevention

Like most STDs, genital warts can be avoided by not having sex or by having sex only with one uninfected partner.

Condoms offer some protection against genital warts, but they can't completely prevent them because the warts can be outside of the area protected by the condom. Spermicidal foams, creams, and jellies have not been proven to protect against HPV and genital warts.

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