Genital Warts

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Superficial mucocutaneous infection

Causes

• Human papilloma virus (HPV): causes viral warts (condylomata acuminata)
• Treponema pallidum: causes syphilitic warts (condylomata lata)
• Molluscum contagiosum virus

Clinical features

• Penis, foreskin, labia and vagina are the most common sites of the warts
• Warts can be variable in number and size, either few or multiple, small to very large
• HPV warts: soft fleshy growth on genitals
• Syphilitic warts: flat-topped and broad based growth
• Molluscum contagiosum: light coloured, umbilicated growths on the face and genital areas

Differential diagnosis

• Rashes
• Eruptive skin lesions

Management

Treatment

• Advise on personal hygiene
• Treat underlying infection

HPV viral warts

• Apply podophyllum resin paint 15% to the warts 1–3 times weekly until warts have resolved; may require multiple weekly treatments
  • Protect normal skin with petroleum jelly before application
  • Apply precisely on the lesion avoiding normal skin
  • Wash off with water 4 hours after each application
  • Do not use in pregnancy

If no improvement after 3 applications

• Refer for specialist management

Syphilitic Warts

• Give: benzathine penicillin injection 2.4 MU single dose (half into each buttock)

Molluscum contagiosum

• Usually self limiting
• Treat underlying conditions that may be compromising the person’s immunity