Condyloma acuminata (Genital warts)
Posted by dkwinter

See also: Vulvar lesions
     Caused by human papilloma virus (HPV) infection
     Females may have internal and/or external vaginal lesions as well as anogenital lesions
     Patients are most often asymptomatic
     Pruritus, pain and bleeding are possible
     Clusters of pink or skin-colored lesions with a smooth, TEARDROP appearance
     Small teardrop-shaped growths at the vestibule of the vulva
     Application of TRICHLOROACETIC ACID results in complete resolution of the lesions
     Can be made based solely on the characteristic appearance of the lesions, although application of acetic acid (condyloma lesions turn white) and/or biopsy may be used to support the diagnosis.
     Depends on the size of the lesions.
     Regardless of method treatment, rates of recurrence are high.
Tx (small lesions)
     May be treated in the office with trichloroacetic acid or podophyllin
Tx (larger lesions)
     Often treated with excision or fulguration (electric current).
     Do not confuse condyloma acuminata with condyloma lata, which is caused by secondary syphilis and is characterized by flat, velvety lesions. They respond to penicillin.
     Vulvar cancer typically presents as a singular, fleshy lesion on the labia majora. Vulvar cancer is commonly seen in elderly individuals and will not resolve with application of trichloroacetic acid.
     Lichen sclerosus presents as white, thin, and wrinkled skin over the labia. It typically affects postmenopausal females, and causes pruritus.
     Vulvar lichen planus typically affects middle-aged women. Lesions may be hyperkeratotis, erosive or papulosquamous in appearance. Pruritus, soreness, and vaginal discharge are common.