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Author: Jane Morgan MB ChB MRCP FACSHP, Sexual Health Physician, Hamilton, New Zealand, 2003. Updated by Hon A/Prof Amanda Oakley, September 2015. Revised February 2021
An anogenital wart is a common superficial skinlesionin the anogenital area caused by specific human papillomavirus (HPV) types. Anogenital warts are also called condyloma acuminatum,genitalwarts, and venereal warts.
Anogenital warts are aninfectioncaused by specific human papillomavirus types, most commonly HPV types 6 and 11. Warts will usually appear three to six months after infection but they may appear months or even years later. Anogenital warts are usually asexually transmitted infection(STI).
Human papillomaviruses (HPV) are a large family of species-specific related double-strandedDNAviruses.
As anogenital warts are usually sexually acquired, they are most commonly observed in young adults between the ages of 15 and 30 years. [seeSexually acquired human papillomavirus] They are highly contagious. However, anogenital warts are rare in people who have been vaccinated against thebenignHPV types in childhood before beginning sexual activity. Anogenital warts have been reported in a number of studies to be more common in males than females.
Patients who areimmunocompromiseddue to drug-induced immunosuppression orHIVinfectionare at particular risk of acquiring HPV and developing anogenital warts.
Anogenital warts can also affect infants and young children. The virus may be acquired during birth or from the hands of carers.
Visible anogenital warts and subclinical HPV infection nearly always arise from direct skin to skin contact.
An anogenital wart is a flesh colouredpapulewith a folded irregular surface a few millimetres in diameter. Warts may join together to formplaquesup to several centimetres across. Alinear可以看到,如果模式the virus has beeninoculatedalong a scratch or tear in the skin. Symptoms associated with anogenital warts can include:
HPV infection may occur in the following anogenital sites:
The same HPV types can also be found inlesionsaround the lips, the oral mucosa orconjunctiva. [seeSquamouscellpapilloma]
Anogenital warts are contagious and spread particularly to sexual partners.
Anogenital warts can enlarge and multiply during pregnancy which may then interfere withvaginaldelivery. HPV can be transmitted to the baby resulting inrecurrentrespiratorypapillomatosisin the infant.
Anogenital warts can impact psychosexual functioning and quality of life. [seePsychosocialfactors indermatology]
Anogenital warts are usually diagnosed clinically.
In some circumstances, researchers and clinicians may wish to confirm the presence or absence of HPV. One commercially available qualitative test for HPV is the COBAS 4800 Human Papillomavirus (HrHPV) Test, which evaluates 14 high-risk (HRoncogenic) HPV types.
Normal anatomical structures may be confused with warts. These include:
Seborrhoeickeratosesare often observed in the anogenital area of older adults.
Anogenitalsquamous cellcarcinomais an important differential diagnosis to consider as the high-risk and low-risk HPV types are both STIs and can be transmitted together.
HPV vaccinationis most effective when offered at a young age, before the onset of sexual activity. However, girls who are already sexually active may not have been infected with the types of HPV covered by the vaccine and may still benefit from vaccination. Women who receive a HPV vaccine should continue to participate in cervical screening programmes.
HPV vaccines are also effective in boys. Vaccination of boys is recommended to reduce transmission of HPV to unvaccinated females. It also reduces theincidenceof cancers in males related to HPV infection.
Transmission of anogenital warts to a new sexual partner can be reduced but not completely prevented by using condoms. Condoms do not prevent all genital skin-to-skin contact, but they also protect against othersexually transmittedinfections.
To be successful the patient must identify and reach the warts, and follow the application instructions carefully. Available treatments include:
肛门-生殖器疣可以解决自发地或在response to treatment. Despite apparent resolution of anogenital warts, the virus canpersistin a latent or subclinical form.Recurrenceis therefore very common, particularly in males.
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