Find information on thousands of medical conditions and prescription drugs.

Condyloma acuminatum

Genital warts (or condyloma, or condylomata acuminata) is a very contagious sexually transmitted disease. Caused by some variants of the Human papillomavirus, typically HPV 6 and HPV 11, it is spread during oral, genital, or anal sex with an infected partner. About two-thirds of people who have a single sexual contact with a partner with genital warts will develop warts, usually within three months of contact. more...

Home

Calculi

Canavan leukodystrophy

Cancer

Carcinoma, squamous cell

Carcinophobia

Cardiac arrest

Cardiofaciocutaneous...

Cardiomyopathy

Cardiophobia

Cardiospasm

Carnitine transporter...

Carnitine-acylcarnitine...

Caroli disease

Carotenemia

Carpal tunnel syndrome

Carpenter syndrome

Cartilage-hair hypoplasia

CCHS

Cenani Lenz syndactylism

Ceramidase deficiency

Cerebellar ataxia

Cerebellar hypoplasia

Cerebral amyloid angiopathy

Cerebral aneurysm

Cerebral cavernous...

Cerebral gigantism

Cerebral palsy

Cerebral thrombosis

Ceroid lipofuscinois,...

Charcot-Marie-Tooth disease

CHARGE Association

Chediak-Higashi syndrome

Childhood disintegrative...

Chionophobia

Chlamydia

Chlamydia trachomatis

Cholera

Cholesterol pneumonia

Chorea acanthocytosis

Chromosome 15q, partial...

Chromosome 15q, trisomy

Chromosome 22,...

Chronic fatigue immune...

Chronic fatigue syndrome

Chronic granulomatous...

Chronic lymphocytic leukemia

Chronic myelogenous leukemia

Chronic obstructive...

Chronic renal failure

Churg-Strauss syndrome

Ciguatera fish poisoning

Coffin-Lowry syndrome

Colitis

Color blindness

Colorado tick fever

Combined hyperlipidemia,...

Common cold

Common variable...

Compartment syndrome

Conductive hearing loss

Condyloma

Condyloma acuminatum

Cone dystrophy

Congenital adrenal...

Congenital afibrinogenemia

Congenital diaphragmatic...

Congenital erythropoietic...

Congenital facial diplegia

Congenital hypothyroidism

Congenital ichthyosis

Congenital syphilis

Congenital toxoplasmosis

Congestive heart disease

Conjunctivitis

Conn's syndrome

Constitutional growth delay

Cornelia de Lange syndrome

Coronary heart disease

Cortical dysplasia

Corticobasal degeneration

Costello syndrome

Costochondritis

Cowpox

Craniodiaphyseal dysplasia

Craniofacial dysostosis

Creutzfeldt-Jakob disease

Cri du chat

Crohn's disease

Croup

Crouzon syndrome

Crouzonodermoskeletal...

Cutaneous larva migrans

Cutis verticis gyrata

Cyclic neutropenia

Cyclic vomiting syndrome

Dilated cardiomyopathy

Hypertrophic cardiomyopathy

Restrictive cardiomyopathy

Medicines

In women the warts occur on the outside and inside of the vagina, on the opening (cervix) to the womb (uterus), or around the anus. While genital warts are approximately as prevalent in men, the symptoms of the disease may be less obvious. When present, they usually are seen on the tip of the penis. They also may be found on the shaft of the penis, on the scrotum, or around the anus. Rarely, genital warts also can develop in the mouth or throat of a person who has had oral sex with an infected person.

Genital warts often occur in clusters and can be very tiny or can spread into large masses in the genital or anal area.

Treatment

Genital warts often disappear even without treatment. In other cases, they eventually may develop a fleshy, small raised growth that looks like cauliflower. There is no way to predict whether the warts will grow or disappear. Therefore, if you suspect you have genital warts, you should be examined and treated, if necessary.

Depending on factors such as the size and location of the genital warts, a doctor will offer you one of several ways to treat them.

Imiquimod, (Aldara®) a topical immune response cream which you can apply to the affected area
A 20 percent podophyllin anti-mitotic solution, which you can apply to the affected area and later wash off
A 0.5 percent podofilox solution, applied to the affected area but shouldn’t be washed off
A 5 percent 5-fluorouracil cream
Trichloroacetic acid (TCA)
pulsed dye laser
liquid nitrogen cryosurgery

If you are pregnant, you should not use podophyllin or podofilox because they are absorbed by the skin and may cause birth defects in your baby. In addition, you should not use 5-fluorouracil cream if you are expecting.

If you have small warts, the doctor can remove them by freezing (cryosurgery), burning (electrocautery), or laser treatment. Occasionally, the doctor will have to use surgery to remove large warts that have not responded to other treatment.

Some doctors use the antiviral drug Alpha Interferon, which they inject directly into the warts, to treat warts that have returned after removal by traditional means. The drug is expensive, however, and does not reduce the rate that the genital warts return.

Although treatments can get rid of the warts, they do not get rid of the HPV virus, so warts can recur after treatment. However, the body's immune system typically clears the virus anywhere from 6 months to a year. There is even some suggestion that effective treatment of the wart may aid the body's immune response. An effective HPV vaccine is currently undergoing a phase III FDA trial and appears nearly 100% effective against the most common types.

Read more at Wikipedia.org

• [List your site here Free!]

What is the most effective treatment for external genital warts? - Clinical inquiries: from the Family Practice Inquiries Network
From Journal of Family Practice, 4/1/02 by Linda French

EVIDENCE-BASED ANSWER

Podofilox (Condylox), imiquimod (Aldara), cryotherapy, and surgical options all seem reasonable alternatives that are superior to podophyllin. (Grade of recommendation: B, based on systematic review.) No studies of surgical options versus home use preparations have been reported. Trichloroacetic acid and 5-fluorouracil (5-FU) have not been sufficiently studied.

EVIDENCE SUMMARY

Nonsurgical treatments that are beneficial in eradicating genital warts are podofilox (Condylox) (8 randomized controlled trials [RCTs] with 1035 participants), imiquimod (Aldara) (2 RCTs with 968 participants), and intralesional interferon (8 RCTs). Cryotherapy is equivalent to trichloroacetic acid (1,2) and electrosurgery. (3) Although surgical treatments have not been compared with placebo or no treatment, both electrosurgery and surgical excision are superior to podophyllin in clinical trials. (4,5) Laser surgery is as effective as surgical excision. (6) Studies of topical interferon show conflicting results. (7) Systemic interferon is not beneficial. (7) Topical 5-FU has not been studied with RCTs. Wan clearance rates are summarized in the Table. Treatment duration for nonsurgical options is 4 to 8 weeks. Treatment of genital warts "has not been shown to reduce transmission to sex partners. (7)

Two RCTs (4,5) showed more frequent recurrence with podophyllin (60% to 65%) than with surgical excision (19% to 20%). Another trial (1) showed recurrence in 22% of participants receiving electrosurgery, in 21% of those receiving cryotherapy, and in 44% of those receiving podophyllin treatment. Data are lacking on recurrence rates with imiquimod, podofilox, and intralesional interferon.

Pain occurs in less than 20% of people with imiquimod, cryotherapy, podophyllin, and electrosurgery; 39% with topical interferon; 44% with electrosurgery; 75% with podofilox; and 100% with surgical excision or laser surgery. (7) However, pain has been measured using methods that are unlikely to be comparable across studies. Flulike symptoms, leukopenia, thrombocytopenia, and elevated aspartate transaminase levels are associated with intralesional interferon. (7) Topical medications have not been studied in pregnant patients. Cryotherapy is safe in pregnancy based on case series, if only 3 or 4 treatments are given. (7)

Direct comparisons between home therapies (imiquimod, podofilox) and other treatments are needed. Products for home use are relatively expensive: a 1-month supply of imiquimod costs approximately $150; a 1-month supply of podofilox, $110 to $130. These are average wholesale prices, rounded to the nearest $10, as of Feb. 15, 2002.

RECOMMENDATIONS FROM OTHERS

The CDC endorses podophyllin, bi- and tri-chloroacetic acid, podofilox, imiquimod, cryotherapy, intralesional interferon, electrosurgery, laser surgery, and surgical excision. (8) A United Kingdom guideline on anogenital warts recommends physical ablative methods such as cryotherapy and surgical options for keratinized lesions and topical medications for soft lesions. The guideline also recommends ablative therapy for persons with a small number of warts regardless of type. Interferon and 5-FU are not recommended. (9)

REFERENCES

(1.) Abdullah AN, Walzman M, Wade A. Sex Transm Dis 1993; 20:344-5.

(2.) Godley MJ, Bradbeer CS, Gellan M, Thin RN. Genitourin Med 1987; 63:390-2.

(3.) Stone KM, Becker TM, Hadgu A, Kraus SJ. Genitourin Meal 1990; 66:16-9.

(4.) Khawaja HT. J Reprod Med 1990; 35:1019-22.

(5.) Jensen SL. Lancet 1985; 2:1146-8.

(6.) Duus BR, Philipsen T, Christensen JD, et al. Genitourin Med 1985; 61:59-61.

(7.) Wiley DJ. Genital warts. Clin Evidence Issue 4, December 2000; 910-8.

(8.) Centers for Disease Control and Prevention. Morbid Mortal Weekly Rep MMWR 1998; 47(RR-1):91-4.

(9.) Clinical Effectiveness Group (Association of Genitourinary Medicine and the Medical Society for the Study of Venereal Diseases). Sex Transm Infect 1999; 75(suppl 1):71-5S.

Linda French, MD, Department of Family Practice, Michigan State University, East Lansing

Joan Nashelsky, MLS, W.A. Foote Hospital, Jackson, Michigan

Clinical Commentary by David White, MD, at http://www.fpin.org.

Return to Condyloma acuminatum

Home

Contact

Resources

Exchange Links

ebay