Anogenital warts caused by the human papilloma virus are the commonest sexually transmitted virus infections of modern age. The risk of transmission of genital HPV infections is directly proportional to the number of sexual partners, unnatural sexual practices and presence of the infection among these partners.
Clinical appearance is sufficient most of the time to make a diagnose of ano-genital warts, though a few laboratory tests are available for the diagnosis of subclinical infections.
How are Ano-genital Warts Transmitted?
Anogenital warts are transmitted through sexual and other intimate contacts. It has been estimated that there is a 60% chance of catching the HPV infection through sexual contact with an infected partner. Though the HPV has been recovered from various fomites and gloves, transmission through these routes are still disputed.
Infants born to mothers with condyloma accuminata may develop growths in the throat (laryngeal papilloma) or genital warts even up to two years of age without any other evidence of sexual abuse. Presence of perianal warts usually indicates receptive homosexual practices in males and anal sex in females. Rarely, though, some individuals may develop perianal warts without any history of such practices.
What are the Risk Factors Facilitating Transmission of HPV?
In women, the chances of acquiring HPV infection increases with number of partners, frequency of sexual intercourse and presence of warts in the sexual partners. Unprotected sex increases the risk in both genders, though condoms do not provide complete protection in males as evidenced by the number of patients presenting with warts on the suprapubic region and the base of the penis.
Ano-genito-oral sexual practices increase the risk of transmission of human papilloma virus infections. Several studies have also pointed out increased incidence of anogenital warts in smokers compared to non-smokers though the exact reason is not yet clear for such an occurrence.
What are the Other Skin Conditions that may be Mistaken for Anogenital Warts?
In males the commonest skin disease confused as warts are the pearly penile papules, the small bumps lining the neck of the glans penis. These are harmless eruptions, the glands present in sexually active males.
Other skin conditions that are considered in differential diagnosis of warts in the genital area are molluscum contagiosum, seborrheic keratosis, moles, skin tags, lichen planus and angiokeratoma of Fordyce.
Are There any Tests to Diagnose HPV Infections of the Genitalia?
Diagnosis of anogenital warts is usually from the clinical appearance alone. Confirmation of diagnosis may be done through a histopathological examination of a biopsy specimen. Three to five percent acetic acid applied for five minutes produces whitening of the warts normally not visible through naked eyes and is a useful tool to diagnose subclinical infections in some cases.
The most sensitive test for HPV is PCR (Polymerase Chain Reaction). Though this can detect latent infections, it is still used a research tool rather than a routine investigation for warts.
Gel electrophoresis and restriction endonuclease cleavage are other methods used to detect subclinical HPV infections.
Ano-genital Warts: Transmission, Risk and Diagnosis of HPV Infections: Related Articles
- Clinical Types of Ano-Genital Warts: Different Manifestations of HPV Infections
- How to Cure Genital Warts and Prevent HPV Recurrences
- External Genital Wart Treatment with Imiquimod
- Treatment Options for Anogenital Warts
Reference:
- Usman N. Anogenital Warts in Sexually Transmitted Diseases and AIDS. Ed.Sharma VK, Viva Books, New Delhi, 2003
- Fitzpatrick's Color Atlas & Synopsis of Clinical Dermatology, Fifth Ed, 2005
Disclaimer:
The information given in this article is for educational purposes only so that patients are aware of the options available. No diagnosis should be made or treatment undertaken without first consulting your doctor. If you do so, Dr.Hanish Babu, MD or Suite101 will not be responsible for any consequences. The images provided are for illustration purpose only.
Hanish Babu - Dr.Hanish Babu, MD is a dermatologist and a feature writer on Suite101.com with more than 200 articles related to skin diseases on the ...
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