Genital Warts

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CLINICAL DESCRIPTION

  • These must be distinguished from condyloma of secondary syphills, molluscum contagioum and vulva cancer
  • Besides local caustic applications, surgical removal or electrocautery may be used for treatment:
    • For more extensive growth
    • When topical applications have failed
    • When topical application is contra-indicated

CLINICAL FEATURESSIGNS AND SYMPTOMS

  • Small, flat, papular, pedunculated, flesh-colored swellings on the skin and mucous membranes of the genitals (penis, vulva, vagina, cervix, urethra, perianal region)
  • Usually no symptoms
  • Small painless swellings in the ano-genital region
  • Itching or discomfort in the genital area
  • May cause increased vaginal discharge
  • Anal or vaginal bleeding during or after sex

INVESTIGATIONS

  • Acetic acid solution (vinegar) test

TREATMENT NON-PHARMACOLOGICAL

  • Apply Compound Podophyllin Paint to the lesions once a week for 6 weeks
  • Apply petroleum jelly to avoid normal tissue damage
  • Use only for scattered growth
  • When applied to vulval mucosa or urethral meatus warts, allow to dry before coming back into contact with normal epithelium
  • Remove the paint by washing off after 4 hours

Note: Do not use this therapy during pregnancy

  • If no effect after 4-6 weeks, stop treatment and consider alternative methods of removal
  • Alternative to Podophyllin Paint, and for treating vulvar warts:
  • Apply Silver Nitrate Stick (pencil) 24 hourly