​Dermatology - Genital Human Papilloma Virus (HPV) Infection

​Dermatology - Genital Human Papilloma Virus (HPV) Infection
The majority of sexually active individuals have subclinical HPV infections, and approximately 1% of sexually active adults between the ages of 15 and 19 acquire lesions. The infection has the ability to remain inactive for extended periods of time and can become contagious periodically. An emerging vaccination targeting certain strains of HPV has the potential to reduce the occurrence of HPV-induced cancer.

The dysplasia of the anogenital and oral skin and mucosa varies in severity from minor to severe.
Warts have the potential to progress into squamous cell cancer. Recurrences typically arise from reactivation rather than reinfection. During pregnancy, warts may have an augmentation in both size and quantity, exhibit heightened vaginal involvement, and demonstrate an elevated incidence of secondary bacterial infection.
Children born through the vaginal canal to moms with genital HPV infection are susceptible to developing recurrent respiratory papillomatosis.
Abnormalities
The lesions, known as condylomata acuminata, vary in appearance from little papules to larger nodules or even merging masses. They can be found on the skin or mucous membranes of the anogenital area, as well as the oral mucosa, including the external genitalia, perineum, cervix, and oropharynx. The lesions can appear in various colors such as skin-colored, pink, red, tan, or brown. They can be either solitary, dispersed, or isolated, or they might form large, merging clusters.


The diagnosis is primarily based on clinical evaluation, and in some cases, it may be further validated with a biopsy. The differential diagnosis includes various conditions, such as normal anatomical variations (sebaceous glands, pearly penile papules, vestibular papillae), squamous cell carcinoma, benign tumors (moles, seborrheic keratoses, skin tags, pilar cyst, angiokeratoma), inflammatory skin diseases (lichen nitidus, lichen planus), molluscum contagiosum, condylomata lata, folliculitis, and scabietic nodules.


There is currently no therapy that has been proven to completely eliminate HPV or effectively prevent cervical or anogenital cancer.
Optimal treatment outcomes are more likely when warts are of diminutive size and have been present for less than one year. Treatment options are determined based on the specific requirements of the patient, with the aim of avoiding costly, harmful therapies, as well as procedures that may lead to scarring. The use of Imiquimod 5% cream or podophylox 0.5% solution by the patient is both efficacious and feasible. Cryosurgery, intralesional podophyllin (10-25%), trichloroacetic acid (80-90%), surgical removal, and electrodesiccation are all viable possibilities for treatment.