Skip to content

Content

Home
Patient case
Patient Case: Genital Warts (Condylomata Acuminata)

Patient Case: Genital Warts (Condylomata Acuminata)

Discussion

A 30-year-old male presents to the dermatology clinic with multiple painless growths on his penile shaft and perianal region. He first noticed a few small bumps six months ago, but they have since grown larger and spread. He denies any pain, itching, or urethral discharge. His medical history is unremarkable, but he admits to having multiple sexual partners and inconsistent condom use.

On physical examination, several soft, flesh-colored, verrucous papules with a cauliflower-like appearance are observed on the penile shaft and around the perianal area. There are no signs of ulceration, discharge, or secondary infection. The rest of the genital examination is normal.

Based on the clinical presentation, a diagnosis of condylomata acuminata (genital warts) caused by human papillomavirus (HPV) is made. The patient is counseled on treatment options, including topical therapies such as imiquimod and podophyllotoxin, as well as procedural interventions like cryotherapy. He is also advised on the importance of HPV vaccination and safe sexual practices to reduce recurrence and transmission risks.

Questions
  1. What is the most likely causative agent of the patient’s condition?
    a) Treponema pallidum
    b) Herpes simplex virus (HSV)
    c) Human papillomavirus (HPV)
    d) Chlamydia trachomatis
  2. Which clinical feature is most characteristic of condylomata acuminata (genital warts)?
    a) Painful, fluid-filled vesicles that rupture and crust over
    b) Soft, verrucous, cauliflower-like papules
    c) Single, firm, painless ulcer with clean edges
    d) Thick, adherent white plaques with a foul odor
  3. Which HPV types are most commonly associated with genital warts?
    a) HPV 1 and 4
    b) HPV 6 and 11
    c) HPV 16 and 18
    d) HPV 31 and 45
  4. What is the most appropriate first-line treatment for genital warts in this patient?
    a) Oral antiviral therapy
    b) Topical imiquimod or podophyllotoxin
    c) High-dose systemic antibiotics
    d) Immediate surgical excision in all cases
Reveal answers

Answers

  1. (c) Human papillomavirus (HPV)
    • Condylomata acuminata (genital warts) are caused by HPV, primarily low-risk types 6 and 11, which lead to benign growths of the genital epithelium.
  2. (b) Soft, verrucous, cauliflower-like papules
    • Genital warts typically present as soft, painless, skin-colored or pink lesions with a verrucous or cauliflower-like appearance, distinguishing them from other sexually transmitted infections.
  3. (b) HPV 6 and 11
    • These low-risk HPV types are responsible for over 90% of genital warts and are not strongly associated with cervical or anal cancer, unlike high-risk types 16 and 18.
  4. (b) Topical imiquimod or podophyllotoxin
    • First-line treatments for genital warts include topical agents such as imiquimod (an immune response modulator) and podophyllotoxin (a cytotoxic agent), while procedural options like cryotherapy are used for resistant cases.