Condyloma acuminata

Background

• Also known as anal warts
• Usually related to HPV 6 and 11, which have less neoplastic potential than other HPV strains

Clinical Features

Anal warts

• Vary from dot-like to large papilliform, cauliflower-like lesions
• Pain, itching, bleeding, anal discharge
• Perianal involvement often associated with vulvovaginal and penile lesions

Differential Diagnosis

Anorectal Disorders

• Anal fissure
• Anal fistula
• Anal malignancy
• Anal tags
• Anorectal abscess
• Coccydynia
• Colorectal malignancy
• Condyloma acuminata
• Constipation
• Crohn's disease
• Cryptitis
• GC/Chlamydia
• Fecal impaction
• Hemorrhoids
  • Internal hemorrhoid
  • External hemorrhoid
• Levator ani syndrome
• Pedunculated polyp
• Pilonidal cyst
• Proctalgia fugax
• Proctitis
• Pruritus ani
  • Enterobius (pinworms)
• Rectal foreign body
• Rectal prolapse
• Syphilitic fissure

Non-GI Look-a-Likes

• Prostatitis

Workup

• Clinical

Management

• Refer to specialist for electrosurgery, cryotherapy, trichloroacetic acid, or surgical excision
• Podophyllin solution/cream
• Imiquimod 5% cream

Disposition

• Outpatient

See Also

• Anorectal Disorders
• Proctitis

References

CDC Centers for Disease Control and Prevention : 2015 STD Treatment Guidelines. www.cdc.gov/std/tg2015/warts.htm