GENITAL WARTS

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

  • 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