genital warts)

genital warts)

Genital warts are caused by infection with HPV and are sexu - ally transmitted. Infection is very common, with only a small - proportion of infected patients actually having visible warts. Most commonly due to HPV types 6 and 11, these viruses do not cause cervical cancer. Ordinary skin warts can occur - on the genitals by direct contact with a finger lesion, but they are less moist and soft and less often pedunculated than the genital variety . T he lesions most commonly occur under the prepuce in the coronal sulcus b ut may be found elsewhere, including inside the urinary meatus and on the outer prepuce ( Figure 85.27c ). In women, genital warts are most commonly found on the vulva, but they may line the vagina and occur on the cervix. Perianal warts are common. ; it Other associated sexually transmitted diseases should be excluded: in women mainly candidiasis and Trichomonas infec - tion and in men syphilis or gonorrhoea. Genital warts may complicate HIV infection. - Treatment is by chemical or physical means. Podophyllin is often e ff ective as a topical application. It is applied to the wart, - taking great care to av oid the surrounding skin, and washed o ff after 6 hours or so. An alternative agent is imiquimod. If chemical methods fail, the warts can be ex cised or they can be ablated with cryosurgery , electrosurgery or laser. Circumci - sion is sometimes advised if there are florid lesions under the foreskin.