Genital warts

Question 1

What is the medical name for Genital Warts caused by HPV infections

(additionally, what HPV subtypes typically cause these warts)

Answer 1

Condylomata Acuminata - Caused by HPV 6 or 11

Question 2

How are genital warts / Condylomata Acuminata obtained?

Answer 2

Transmitted via skin-to-skin contact

Condoms do not provide full protection against genital warts

Question 3

What are the symptoms experienced from Condylomata Acuminata?

Answer 3

Warty growths around and INSIDE genital skin - often ASYMPTOMATIC
- as they can be inside, all women who have external warts should undergo SPECULUM EXAMINATION to evaluate for internal warts - these may require colposcopy or follow-up to ensure resolution

Maybe multi-focal (can grow at sites which haven’t undergone micro-trauma/exposure)
Can be solitary or multiple

Bleeding may be experienced from Cervical / Urethral / Anal lesions

Question 4

What are some serious differentials to consider with Genital warts?

Answer 4

Condylomata lata (occur in secondary syphilis)

Chancre (painless ulcer of primary syphilis)

Malignant + Pre-malignant conditions (including PIN/VIN)

Question 5

When do you refer Genital Warts

Answer 5

You are unsure

Internal lesions

Suspicious lesion (eg Pigmented/depigmented, Pruritis, Immune-deficiency, Prior history of intraepithelial neoplasia)

Immunosuppressed patients

Pregnant women

Children

Elderly patients (?Malignancy)

Question 6

What is the management of Genital warts (condylomata acuminata)

Answer 6

Screen for other STIs
Give written information
Encourage condom use (reduces risk of transmission, doesn’t eliminate)
Reassure - HPV is common and often clears spontaneously

Question 7

What are the complications/considerations for Genital warts in pregnancy?

Answer 7

Very common in pregnancy due to immunodeficiency

Very low risk to baby + normal delivery anticipated
» 1 in 25000 risk of Respiratory Laryngeal Papillomatosis

Topical cream treatments contraindicated due to teratogenicity