What is an exophytic condiloma or papilloma acuminata?

These are usually small external warts also called condyloma acuminata, rooster-comb, and also venereal vegetation. These lesions are always benign but they can be aesthetically embarrassing, easily irritable and moreover very contagious.

The latency period of this type of lesion is estimated to be around 6 months.

The lesions can appear on the woman's vulva (large and small lips), on the pubis, perineum or anus and anal canal, more rarely on the upper thighs, on the gluteal cleft, or even the urethra. It is also vital to verify the absence of internal lesions in the vagina or the cervix by performing a colposcopy. As regards males, lesions may appear on the penis sheath, the foreskin, urethra and possibly also on the peri-anal region or in the groin area.

These lesions are caused by low-risk Papilloma viruses HPV 6 or 11 which are effectively prevented with vaccination by the quadrivalent vaccine Gardasil ® that protects against HPV 6, 11, 16 & 18. However, this vaccine is only efficient before any lesions have developed.

  • What are the treatments for HPV?

    Appropriate treatment depends on the quantity and extent of the lesions:

    When many lesions are present, immunostimulatory treatments such as imiquimod (aldara®) are proposed. Should this not be successful then treatments targeting the destruction of the virus using laser, electrocoagulation etc. is proposed.

    Sometimes several different treatments are required.

  • Should one avoid unprotected sex? Even though condoms don’t protect completely against this type of lesions, which can be present on exposed areas, it is recommended to use a condom during sex until completely healed.
  • Does smoking make this type of lesions worse?

    Although tobacco smoking is not a direct contributory factor, it does reduce the immune system’s defenses and so the HPV virus can persist.

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