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WARTS - ANOGENITAL
Anogenital warts (condylomas) are caused by human papillomavirus (HPV) with >90% of the lesions caused by genotypes 6 & 11.
Patients who present with visible warts may also be infected with high-risk HPVs (eg types 16 & 18) which can cause subclinical lesions that are associated with intraepithelial neoplasia, cervical cancer and anogenital cancer.
Many HPV infections are subclinical, transient, and clear spontaneously within 12 months but may also remain latent and reactivate after several years.

Patient Education

  • Patients should be given a detailed explanation of their condition
    • Untreated lesions may increase in number or size, remain unchanged or resolve spontaneously 
    • Clearance can take up to 1-6 months, recurrence may occur, and complete eradication occurs later
    • Emphasize the long-term implications to their health and their partners
  • Patients should be advised on the use of condoms
    • Condoms have shown protection against genital warts by preventing the acquisition of human papillomavirus (HPV) infection and continued re-exposure to the virus
  • Patients should be informed that coital rest throughout therapy is recommended
    • It will help decrease adverse reactions (eg pain, discomfort)
  • Emphasize the importance of screening patients for sexually transmitted infections (STIs)
    • Many patients who present with anogenital warts may have other STIs and an appropriate screening for STIs should be recommended
    • Screening for warts and other sexually transmitted diseases (STDs) may be beneficial to the patient and the sexual partner
  • If required, treat sexual contacts
  • When psychological distress is apparent, counseling may be appropriate
  • Pregnant women with anogenital warts should be counseled that cesarean delivery is not performed solely to prevent newborn HPV infection
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